THE MUFTIC FORUM
Winter Park, CO 80482
ph: 303 810 0809
feliciam
BLOG POSTINGS
BLOG POSTINGS PRIOR TO 2011
Should Christians respect Obama?
June 21, 2010
"Should Christians Respect Obama? This is an email I have received at least 3 times this spring. As an active and practicing Christian, my question is: should Christians respect the writer of the email or those who forward it on to others?
That kind of blanket hate spewing at anyone who is Muslim or had a Muslim father but was raised by and is a professed Christian is extremely un Christian. It seems like some people think that it is Christian to promulgate hatred. I abhor it. Christ had a very different message than hating . I just don't see where these preachers get their theology...or is it politics?
If we embrace a jihad against all Muslims (like a crusade) we have become the same as our enemy, those who are practicing terrorism , and make conduct of our foreign policy impossible in dealing with everyone else in the Muslim world who is not an Al qaeda affiliate or a wannabee. What should we want: make them all hate us, too? Focus on the individuals and organizations within Islam, which are only a small faction of their religious practictioners, but to take on all of Islam and to question the loyalty of our President with guilt by association of having a father he saw twice in his life is flat wrong, un American, and un patriotic and it hurts our own country. Come on. Stop promoting this, approach that does nothing but fuel terrorist passions.
Let's return to Christ's real messages of caring for the least of these, welcoming small children,blessing the peacemakers, toleration of those who are different including heathens (per St Paul) or the lesson of the good Samaritan. I thank God for sending Him with those kinds of messages. I wish He were physically alive today to forward those great words to all as a viral email.
Romanoff camp complains to the Sky Hi Daily News
May 27, 2010
I have been called a Communist, Nazi, Socialist and worse by those who have emailed me and few have objected,..however, the Romanoff press person called the editor of the Sky Hi Daily news to complain about the unkindest cut of all...he called me a Bennet delegate.(which I was to the county assembly) ..and therefore should DQ myself as an opinion columnist on the issue. He complained that my reference to the Romanoff position on his role in opposing the dream education issue was incorrect and that I wrote it because I was slanted in my view point. (It appeared he got an advanced copy of my column in which I referred to a spat regarding the support that Romanoff had given and the role he played in an issue dear to the heart of some Hispanics....and the editor of the paper excised that reference in my column before it ran...and the paper caved ) The Denver Post article from which I got my information is the following and you be the judge: The excised paragraph: The importance of the Hispanic vote is playing out in the Colorado Democratic senate primary. Some Hispanic groups have criticized Andrew Romanoff’s 2009 support of state legislation that limited US born children of illegals’ access to instate college tuition. If his primary opponent, Sen. Michael Bennet succeeds in turning more Hispanic votes away from Romanoff, he, too, could benefit, both in the primary and in the general election. Before the Arizona law erupted on the national scene, the two had split Hispanic leaders’ endorsements. stating that some in the Hispanic community criticized Romanoff on his role in passing legislation that kept children of illegals from getting in state tuition?
The source of that comment:
Colorado's U.S. Senate candidates moved quickly to their partisan corners in the immigration debate, with the only doubts coming from critics questioning the ferocity of their various commitments. View Full Story If this does not link correctly, go to www.Denverpost.com, and look for Michael Booth's article on the issue May 3 and again May 5, 2010. Scroll down to comments near the end.
Immigration: What's wrong with the AZ law
May 6, 2010
Some readers must have missed the point of my column on immigration. In plain black and white: when people are determined, no wall nor barbed wire can keep them out; that the burden on law enforcement to avoid racial profiling is a very hard one, if not impossible. Right on one thing: immigration laws are lax. As Peggy Noonan remarked on TV the other day, businessmen (mostly Republicans) like cheap labor; Democrats like the potential voters; that's why nothing will probably be done. One thing we can do is to make sure those who are here legally do not have their civil rights trampled on and so long as yours and mine...civil rights...are not attacked, most Americans do not care about whether others'civil rights are in jeopardy. Some outside force... such as the Justice Department...and our Supreme Court ..have that duty: to protect the civil rights of all...or else someday the shoe may be on the other foot.
Individual mandates to buy health insurance: fine unenforceable
April 19, 2010
Per www.healthreformwatch.com, Seton Hall Law
"In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.”
Nor can the IRS seize your property, because the law states (also on Page 336) that the health and human services secretary may not “file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty … or levy on any such property with respect to such failure.”
Whose taxes go up; whose go down with new health reform law
April 6, 2010
Great link to Kiplinger Letter
Health reform law helps increase Pell grants, eases paybacks on student loans
April 3, 2010
Per the Colorado Democratic Party
This bill invests more than $40 billion in the Pell Grant program to ensure that eligible students receive an award, and that awards increase to keep pace with rising inflation. To ensure that Americans can afford their student loan payments, the law also expands the existing income-based student loan repayment program. New borrowers who assume loans after July 1, 2014, will be able to cap their student loan repayments at 10 percent of their discretionary income and, if they keep up with their payments over time, will have the balance forgiven after 20 years.
Public service workers – such as teachers, nurses, and those in military service – will see any remaining debt forgiven after only 10 years. More than 1.2 million new borrowers are projected to qualify and take part in this new benefit. And this legislation provides $2.55 billion in mandatory funding for Historically Black Colleges and Universities and other Minority Serving Institutions.
The Health Care and Education Reconciliation Act also includes $2 billion over four years for community colleges. As the largest part of the nation’s higher education system, community colleges enroll more than 6 million students and are growing rapidly.
The law pays for these investments and contributes to reducing the federal deficit by ending government subsidies currently given to banks and other financial institutions that make guaranteed federal student loans. According to the Congressional Budget Office, ending these wasteful subsidies will free up nearly $68 billion for college affordability and deficit reduction over the next 11 years.
IRS will not penalize individuals who fail to get mandated health insurance under new law
Reported by MSNBC, April 2, 2010
--Maggie Mertens
Read more: http://today.msnbc.msn.com/id/36135106/ns/health-health_care/#ixzz0k3Qk19Z0
HOW TO TWIST A POLL OUTCOME
March 29, 2009
I do not know if you saw the pop up on this (Sky Hi Daily News) web site the other day, but it was a marketing gimmick for news max, a conservative news service, shilling for potential signers on. It was a screaming picture of Pres. Obama in a surgeon garb...with big letters: STOP HIM NOW
What kind of people do you think would click the link? Not those in synpathy with Obama except the curious.
So I clicked and it was a "poll". The questions were geared for a sympathetic answer: to paraphrase, since the pop up disappeared in a few minutes: should the rich pay be taxed to pay for Obama care, is Obama care too expensive, would would sign on to a public plan if it was cheaper and who did you support for Pres. in 2008?
I wish they would have included questions like: Is it ok for 44,000 people to die every year because they do not have insurance; is it ok to be excluded for getting insurance because of pre existing conditions? etc etc
Wonder what the outcome would be then? Probably similar, since those to whom the ad was directed had already come to the conclusion that they did not want to pay for those who could not afford or qualify for health insurance...Sad. Felicia
HOW OBAMA CARE WILL IMPACT SMALL BUSINESS
March 28, 2010
Here are the provisions of Obamacare that impact small business: Note: you have fewer than 50 employees and you will be exempted from mandates, plus you will be able to eventually tap onto a large pool or group plan if you do provide insurance and until then, you, if you have 25 or fewer employees, you are going to get a credit of 35% of the cost of giving your employees insurance until the pool kicks in. Unclear to me is whether those employees are full or part time in their 50 count threshold. However, if you hire a lot of young people 25 years old or under and they are covered by their parent’s health care plan, then you certainly would not have to pay a fine if you do not cover them. I agree with some of the criticism, that if you plan to take on ten more full time employees, you may cross that threshold and it would be a detriment for expansion beyond 49 full time employees. Other than that, it is beneficial for small businesses.
Per an upcoming column: by Felicia
Small Business and self employed: Per An excellent article in March 24 Hispanic Business: “One of the most immediate effects is a tax credit that would start this year, covering up to 35 percent of the health insurance contributions small firms make for their employees. Another presumed benefit, to be launched in 2014, is creation of state-run exchangeswhere small companies would be able to find more affordable health policies. But a worrisome provision in the House bill, also to kick in that year, would subject companies with at least 50 employees to a $2,000 penalty for each employee they don't cover who winds up on a government-subsidized plan.” Full article: www.hispanicbusiness.com. My note: Construction companies are exempted only if they have 5 or fewer employees, a provision no doubt subject to future amendments.
Young adults: If parents declare them as dependents now, they can stay on their parents’ health plans until they become 26. Beginning in four years, once over 26, they will be required to carry health insurance. However, if they cannot afford it, they will receive a credit or subsidy to buy it based on a sliding scale of income.
From: White House/ Colorado Democratic Party summary: In 2010 the bill will:
- Make providing employee coverage more affordable for small businesses by giving a tax credit of up to 35% of premiums to small businesses that choose to offer coverage.
PR CNN, March 21, 2010: Companies with more than 50 employees that don't provide coverage are required to pay a fee of $750 per worker if any of its employees rely on government subsidies to purchase coverage.
The compromise package would drop the individual fine to $695 or 2.5 percent of income, whichever is greater. The fine on companies failing to provide coverage would jump to $2,000 per employee.
WHAT OBAMA CARE WILL DO FOR GRAND COUNTY
March 25, 2010
On March 24 many not following news developments closely awoke in shock to learn that Obama’s health care reform bill was now law. My phone rang off the hook. What does this mean for me? No wonder. Not only was passage of this a bleeping big deal (to paraphrase VP Joe Biden) , it is also a bleeping large bit of legislation with multi impacts on a large number of different groups of citizens.
I posted a short form summary supplied by the Colorado Democratic party on my web site, www. Mufticforum.com which give highlights. Note: parts of the law take effect at once but others are phased in over four years. Not all 32 million extended access will be covered immediately. The summary does not include all of the details nor does it highlight some provisions of greatest interest to us in Grand County. I began thinking about this in terms of local interests:
Small Business and self employed: Per An excellent article in March 24 Hispanic Business: “One of the most immediate effects is a tax credit that would start this year, covering up to 35 percent of the health insurance contributions small firms make for their employees. Another presumed benefit, to be launched in 2014, is creation of state-run exchanges where small companies would be able to find more affordable health policies.
But a worrisome provision in the House bill, also to kick in that year, would subject companies with at least 50 employees to a $2,000 penalty for each employee they don't cover who winds up on a government-subsidized plan.” Full article: www.hispanicbusiness.com (search key words, health care reform small business).
Young adults: We have a large population of those enjoying the ski and outdoor lifestyle between jobs or just out of college. They can stay on their parents’ health plans until they become 26. Four years from now, there will be a mandate; all not on parents’ plan will have to have health insurance just as they do car insurance. However, if they cannot afford it, they will receive a credit or subsidy to buy it based on a sliding scale of income. That they cannot afford it is no excuse; the subsidy will enable them to afford it.
Graduating soon or seeking a new career? Four million new jobs in health care will be created and immediately new student loan programs will make it easier to get a career education in the field.
Health care: The Rural Health Network should sit up and take notice. Funding for Community Health Centers will be available for rural, underserved areas.
Lower middle income? Medicaid eliigibility will be extended to more of the low income and in four years, those who fall in between eligibility for Medicaid and Medicare age may be able to qualify for subsidies and access to the new exchanges which is similar to the same plan available to member s of Congress. Families of 4 making under $88 thousand a year will qualify.
The consumer protections, outlawing insurance companies to deny insurance to pre-existing conditions, or dropping you when you are sick, or arbitrary insurance caps, will apply to those who have employer provided insurance or individually and CHIPs immediately
If you have a pre-existing condition, you will not have to wait four years for the exchange to be set up to afford insurance. A “high risk pool” will be established in the interim so you can get affordable insurance.
Seniors: You will see no change in benefits traditionally supplied by Medicare. If you are on Medicare advantage (combined Medicare and a supplemental provided via retirement plans) , in about a year, you will have to get your supplemental from a separate company like AARP or AAA. Immediately, the presecription donut hole will be mostly closed and you will not have co pays on annual checkups.
Taxes? Only if you make more than $200 or $250 thousand per year, will you be hit.
WHAT THE NEW HEALTH CARE REFORM LAW WILL DO FOR YOU
March 23, 2010
Courtesy of the Democratic Party and the White House
HEALTH REFORM AND WHAT IT MEANS FOR YOU
- The health reform bill passed last night is a victory for all Americans -- families, seniors, workers and small businesses. Americans now have the security of knowing that they will not have to watch the American dream slip away if they get sick or are in an accident.
- Beginning this year, health reform will bring down costs for families and small businesses, it will end the worst insurance company practices and it will expand coverage to millions of Americans.
- This year, Americans will start to see significant benefits because of this bill and other important reforms will follow.
American families and small businesses will see costs go down immediately because of this bill.
In 2010 the bill will:
- Make providing employee coverage more affordable for small businesses by giving a tax credit of up to 35% of premiums to small businesses that choose to offer coverage.
- Create a temporary high-risk pool to provide affordable insurance options to adults who are denied coverage because of pre-existing conditions.
- Provide a $250 rebate for Medicare recipients who fall in to the Part D donut hole – the first step towards closing the donut hole for good. The bill will also provide a 50% discount on prescription drugs which fall into the donut hole beginning in 2011.
- Require new private plans to cover preventative care – with no co-payments or deductibles. Medicare will also provide free preventive care beginning January 1, 2011.
- Create a temporary reinsurance program for early retirees – this will help employers and retirees age 55-64 struggling to pay expensive premiums
Health reform will immediately expand coverage
This year:
- Insurers will no longer be able to deny children coverage because of pre-existing conditions – this applies to new plans and grandfathered group plans. Never again will insurance companies be able to deny coverage to a child because of his or her health.
- Young adults will be able to remain on their parents’ insurance policy until they turn 26 – this applies to new and grandfathered plans.
- Americans will be guaranteed access to the care they need. Insurance companies will no longer be able to drop coverage when someone gets sick or impose lifetime caps – restrictive annual limits will be banned for new plans and grandfathered group plans.
In the next fiscal year:
- Community health centers will be able to nearly double the number of patients they treat over the next 5 years with additional funding.
- New investments in the bill will increase the number of medical professionals throughout the country – we’ll have more primary care doctors, nurses, nurse practitioners and physician assistants.
Immediately, health reform will strengthen consumer protections and reign in insurance companies.
- This bill will ensure consumers can appeal decisions private insurers make about their plans by creating a new, independent appeals process beginning this year.
- The bill will crack down on insurance companies and ensure they are spending your premium dollars on medical services – in the individual and small group market, insurers will be required to spend 80 percent of premiums on medical services and for the large group market, they’ll be required to spend 85 percent. Insurers who don’t meet those requirements will have to send rebates to policyholders. This will begin on January 1, 2011.
- Insurers will no longer be able to discriminate based on income beginning this year. For new group plans, insurers will not be able to implement eligibility rules that unfairly benefit higher-wage employees.
- This bill will end the practice of unreasonably hiking up rates beginning in 2011. Insurance companies will be required to submit justification for all premium increase requests. Companies who make excessive increases or cannot justify increases, may not be allowed in the new health insurance exchanges.
- The bill will help states create consumer assistance offices with funding coming this fiscal year. These offices will help consumers file complaints or appeal decisions from insurance companies.
Health Care Reform: Beneficial for Every American
The health care bill that passed on Sunday is a landmark victory for every American, regardless of political affiliation. It is time to clear the air of the myths that have polarized our nation by spelling out the benefits of this health care reform bill for our fellow Coloradans.
First, the bill will make affordable, quality health insurance available to 95% of Americans. This means that over 826,000 Coloradans who are currently uninsured will finally be able to insure themselves and their families.
Second, the bill contains lifesaving improvements to Medicare, an important safety net for some of our most vulnerable communities. Seniors will be given free preventive care under Medicare, and the infamous Part D “donut hole” will be eliminated by providing a 50% discount on many brand-name drugs. Over half a million seniors in Colorado will benefit from these measures.
Third, several new restrictions on insurance companies will calm the nerves of millions of Americans who fear losing their coverage. For example, insurance companies will be prohibited from taking coverage away from people who get sick and children who have preexisting conditions. Moreover, they will no longer be allowed to place lifetime caps on coverage, and annual coverage limits will be restricted. Young people can also rest easy knowing that the bill requires providers to allow them to stay on their parents’ policies until they turn 26.
Fourth, our small businesses are struggling to provide coverage to their employees. Under the new bill, tax credits will be provided to small business owners to make coverage more affordable.
Finally, Republicans claim that Americans will be crippled by the cost of this bill. In fact, 95% of Americans will not see their taxes rise one cent. They will actually see their health care costs decrease as premiums and out-of-pocket expenses are lowered over time.
The benefits of this health care bill are far-reaching with no extra cost for most Americans. Let’s all recognize that health care reform is not just the morally right thing to do, but also the smart thing to do. It is the patriotic thing to do.
BLOG POSTING WRITTEN BY FELICIA MUFTIC, MARCH 23, 2010
MANDATES
The announcement by Colorado’s Attorney General John Suthers that he would join some other Repbublican AG’s to challenge the just passed health care reform legislation continues the unfinished debate about mandates. While it would give us the right to go without insurance, it is also a freeloader protection plan at our expense.
Who does not like the idea of the freedom not to have to pay taxes or have to have insurance. Yes, it is one of those issues that on the surface has political appeal, but has nasty consequences because it cripples the ability of the health care legislation, to provide access to health care for almost everyone, regardless of health or income challenges, at a price we can afford to pay. It would allow anyone to skip out yet get health care in a way that would hurt everyone else who has insurance.
If successful, the AG suit will harm two very critical parts of the health reform bill. …one, extremely popular: preventing denial of insurance coverage for those with pre existing conditions or who are sick and increase the costs significantly to cover those 32 million who cannot now afford or qualify for insurance.
Leaving the legal arguments up to the lawyers and probably the supreme court, here is why the mandate is so critical. The mandate requires everyone to have insurance if you do not have insurance through your employer or on your own. Even if you are required to buy or have health insurance and you cannot afford it, there will be a government subsidy based on your income to make it possible to purchase it. Your rights in that sense are not violated….and that will probably be the winning argument that drives a nail in the coffin of the AG’s arguments.
Why were mandates, anyway? The reason is based on a concept that is basic to all insurance plans: the pool. The common term we use today is “group plan”. The healthier the group of those insured, the cost of covering that sick employee is offset by a large number of healthy premium payers who do not file many claims. If the pool is small, as it is with small businesses, then one sick employee can result in unbearable premium rates to the employer. That is why a pool, or the exchange being established in the legislation, or the group plan must be very big and require even the healthy to participate.
One major driving force for health care reform has been this: private insurers have made their companies very profitable by insuring only those who are healthy. However, that leaves millions in the US who cannot afford premiums and who go to the emergency room after they are so sick they are expensive to treat. They do not have insurance to cover annual physicals, prenatal care, or other preventative care. The cost of that is now passed or shifted to families who pay insurance premiums to the tune of $1000 per year.
Obama’s new law will provide affordable access to insurance for 32 million of those without insurance now. Those who would have the freedom not to participate in the program, courtesy of the AG suits, could still get a free ride at our expense in the ER, leaving the exchange with a pool of less healthy, with pre-existing conditions, and high costs to the taxpayers. ER medicine costs would be passed on to you, the insured.
The mandate will not go into effect for four years. Neither will the exchange (the large group plan like Congress has) be operable until then. It may also take that long for the AG’s suit to wend its way through the legal system. The AG action will not delay the law taking effect now. In the meantime, it will be the stuff of political talking points ad nauseum.
Ted Muftic on why the AG suits against mandates will fail
March 24, 2010
Why the 13 AGs suit against the health care mandate will fail.
The best analogy is car insurance which is mandated by every State.
The opponents of a health care mandate say that car insurance is different because you have a choice to drive or not to drive, and if you choose to drive than you have to buy car insurance. It is tied to a choice and not to just being a "citizen". Sounds good..right...but it is not quite the right argument.
At one point in our past, there was no mandate to buy car insurance. If you wanted to drive, thought you were a good driver, and wanted to take a chance..you could drive and not buy car insurance..and if there was an accident you could pay for the damage.
But guess what? Accidents happened. And sometimes you totaled your car and someone else's car and maybe even killed someone. And people did not have the cash to pay for the damage to the other person's car. If the other person was not at fault, and had car insurance, their car insurance covered their damage because risk was spread between all the people who had car insurance with the same insurance company. But what if there were so many accidents happening and not enough "not at fault drivers" with car insurance to spread the risk -- guess what?? Car insurance premiums started to sky rocket and soon people demanded that something be done.
So every state made it a mandate to buy car insurance becuase there were a lot of drivers who just turned out to be not very good at taking the chance at not buying car insurance.
Today..there are folks who still think they are good enough drivers, or folks that are too poor and cannot afford car insurance or have such a bad driving record that they are even denied car insurance -- and yet they choose to drive anyway. And guess what, if they get caught, they have to pay a penalty and may even get thrown in jail!
Now....I can assume that there are a lot of people who think they are young enough,healthy enough, and rich enough to not buy health insurance -- that the chances are heavily in their favor that they never need it and therefore chafe at the idea of being forced to buy it.
But...accidents happen...they get sick...maybe they really have unhealthy habits, bad genes, bad luck or an accident that is totally not their fault. They don't have money to pay for the services of a doctor, or pay for the hospital or pay for that device that will keep them alive. Now truth be told..society could just let them die or suffer or rot..but for the greater good, for a sense of protecting our own humanity and doing all to protect a life, society does the right thing, the moral thing.
But morality in this case has a financial cost. A cost that is borne by those with health insurance who see their own premiums skyrocketing to the point that they decide to take a chance and not buy health insurance and soon there are just too many folks taking a "chance" and the system breaks down.
So...why won't the states now mandate health insurance like car insurance ostensibly to solve similar problems of reckless risk taking or arrogant feelings of invulnerability? [And in the case of health insurance it is even worse because it truly is a free option, a win/win situation. You can take the risk of not buying insurance because while you may have to pay to fix your own car..you won't have to pay a dime to stay healthy..]. I don't know why. Politics? Jobs? Insurance lobby? Bribes?Stupidity?
Truth be told that the States have had the chance for decades to step up and deal with this insurance conundrum like they did with car insurance. But they haven't..and now the Federal govt is going to step in and take over from the States. And either under the "Interstate commerce" clause or the "right to tax" clause or many other clauses in the Constitution, the Federal Gov't has every right to take over when the States have failed on their own to act for general good -- Anyone remember the Civil War?
So..I don't know what these AG's are doing? Maybe we can save that for later.
Why retail sales are up; consumer money freed to spend when in foreclosure
March 12, 2010
by Ted Muftic
With the number of foreclosures and the growing shadow inventory of seriously delinquent mortgages, people are not paying their mortgages, many are still living in their homes and many are now renters at lower monthly costs than their previous commitments.
No wonder consumer sales are going up…A lot more discretionary spending now freed up to buy stuff made in China….
But be aware that the problems of our banking system are just getting kicked down the road and we still have a long way to go before capital starts to free up for loans to small businesses and job creating ventures…. This is a picture of an economy that is getting “stimulated” in all sorts of ways but the underlying causes of its funk have not been addressed.
http://finance.yahoo.com/news/Feb-retailsales-report-offers-apf-1987239262.html?x=0
SOS FOR PUBLIC SCHOOLS
Feb. 8, 2010
I have just posted a reproduction of an article that appeared in the Arapahoe Herald, the award winning student newspaper of Arapahoe High School in Littleton Public Schools. It is a report of a school board meeting of cuts in funding, and cuts in programs. It was partially an inspiration for my column on SOS for public schools, which appeared in the February 8 2010 Sky Hi Daily News. Full disclosure: one of the writers, Sydney Streicher, is my granddaughter. The other inspiration came from my daughter and another granddaughter, their story cited in the Feb. 8 column. Another other part of the inspiration came from those in the Grand County community who personally expressed their agony over cuts in the East Grand school budget and the threatening of school closures. To view the Arapahoe Herald article,go to the page regarding education funding
Why cherry picking popular provisions of health care reform will not work
January 27, 2010
here's the problem with just doing pre existing problems alone...it is called risk pool. If insurers are forced to take the sick and hard to insure, their losses go up and they then increase the price of premiums to cover it or go out of business. The only way to offset that is to bring young and healthy into the total pool of what they cover so they can average it out. Young and healthy usually cannot afford nor do they have insurance because they think they willl live forever. ...and the only way to get them into the pool is a mandate. Hillary was right.
However, the other way is to provide government coverage and let the taxpayers pick up the cost...that is the public option or subsidized private insurance because someone has to make it affordable to them if they are required to have it. Or...have taxpayers cover the hard to insured. Or...put the whole mess into a comprehensive plan that takes money from another pot...such as Medicare ,,.. to have taxpayers subidize. The latter is the Senate bill.
Republicans talk a good game about a piece meal, lets start over...but what they are proposing is the cost, without the savings or a way to pay for it...and when the CBO provides the score, someone is going to have a heart attack and nothing will get done.
The only answer right now is for the House to vote for the Senate bill as is and to tweak it later with amendments when only 51 votes are needed in the Senate. This must be done pronto and I think, given Plouffe's statement yesterday, it will happen.
Felicia
Supreme Court ruling: a blow to populism
January 23, 2010
The new catch word du jour is “populism”. Populism is a term usually scorned by elected officials because it ignores the issues of unintended consequences, facts, figures, studies, and offsetting special interest pressures. Even our founding fathers feared populism, making our new government representative instead of a direct democracy. The business of government was better conducted by those who were well educated and the elite, they thought. In fact, they even feared the representatives elected to the House every two years, so they balanced popular pressure by constructing a Senate, staggering its turnover by only a third being elected at any one time and making the length of terms six years.
The result is a built in tension between the ever shifting public moods, usually fueled by pain of the moment, and a much more cautious, slow moving government. Some current examples of populism include The Tea Party movement and consumerism. Environmentalism , anti growth activism, tax protesters, and anti big government advocates are part of modern populism, too.
Unfortunately, racism and hatred of those of other religions, hatred of foreigners and immigrants, hatred of all business corporations and profits, ultra nationalism and chauvinism, class warfare, opposition to technological advances, anti education or intellectuals , anti change or fomenting revolution to get extreme change are the uglier elements of populism.
Lynching, posse hangings, witch hunts , pitch fork justice, tar and feathering , mob violence have haunted our country since its beginnings, as populist fueled acts resulted in destructive, unfair action.
So, is populism necessarily a dirty word? No. It is part and parcel of democracy and the tension between elected officials and populist fervor is also one of the signatures of our democracy. In some societies, those that do not allow freedom of speech and press, or oppress those who disagree with the ruling government, that tension results in revolution, sometimes bloody. The safety valve is allowing open discussion, freedom to assemble, access to press and media, and to make it easy for all to participate in the elective process. These first amendment protections were established by our country’s founders to allow populist sentiment to be expressed.
The recent Supreme Court decision allowing corporations to advertise without limits for their pet projects and to intimidate those who advocate for positions that would harm their profitability is one that is a potential enemy of populism. Corporations have money to buy TV time and to communicate in a way that can drown out competing messages. They can lie, they can twist truths, present bogus studies to prove their points.. Unlike advertising for products, there are no consumer protection laws to stop them or anyone else.
While corporations cannot contribute to candidates directly, they can name those who buck them and they can threaten legislators to take their position by letting them know that if they oppose their interests in the legislative process, they will run ads either for their opponents in the next election or sponsor ads that will shed bad light on their positions.
While the Supreme Court ruled that corporations had the same rights as individual citizens in the election process, they did uphold the requirements of full disclosure of the sponsor of advertising and campaign material. That puts the responsibility on citizens to read the flash of that disclosure at the end of the ad running in fine print across the bottom and consider the source.
Depending on the internet for fundraising and information is a two edged sword, with both sides in a political firestorm using and abusing it. That media is ever more demanding of “buyer beware” .
Vigilance is not enough. It requires time, focus, and sophistication. Therefore, we also need legislation to remove the imperative for candidates and issue advocates to raise large amounts of money to get their messages across. The playing field should be leveled by limiting the amount of money corporations and individuals can spend, with no exemptions. To insure first amendment freedoms, elections should be tax payer funded, with free access to television and radio and the mail .
The answer may also lie in removing corporations’ status as persons in the eyes of the law when participating in the political process. It will take a different Supreme Court than the one that we heard last week. In 1886 the Supreme Court ruled that corporations were persons, with good reason, since it would allow other persons to take legal action against a corporation that wronged them; the court last week ruled it applied to political advocating, undoing all past legislated constraints. The concern now is whether the power of corporations will trample the voice of individuals exercising their rights in a democracy, and denying populists an ability to have a voice that can be heard.
Felicia Muftic is the author of the Colorado Consumer Handbook, former executive director or board member of many consumer protection agencies, and a former radio talk show host with focus on consumer protection and rights.
Felicia Muftic's comments about why cherry picking "popular" parts of health care reform will not work
January 21, 2010
Those who think cherry picking only "popular" parts of the Senate bill is the way to get 60 Senate votes need a reality check: By requiring insurance companies to cover those with pre existing conditions and not controlling their costs or providing a greater base of healthy customers to average out the cost of the coverage is really dumb. The cost of insurance would indeed soar without the other half that would control costs and make it economically feasible. Insurance companies must average out their payouts...counting on the healthy and the ones who do not file claims to help pay for the really sick or the uninsured. That is why all were required to have insurance, to provide the base to spread out the risk.
Those who think that dropping the cuts in medicare administration would be popular, have no concept about how the demands on the medicare funds will eventually bankrupt the fund, become 90% of our federal debt, or cause either massive tax increases or cut in coverage or increasing the age qualifications in the future. This cut in admin costs must be done unless the cost of the Medicare program swallows us up and eats the program into enormous changes. The major cost is the $177 billion in over charges incurred when Medicare was outsourced to the private sector via the Advantage Program.
Therefore, the cost cuts MUST be included in the package or else indeed this will bankrupt us. Just cherry picking consumer protections would be a disaster and I support the House conforming its vote to the Senate and then coming back later to tweak it when only 51 votes in the Senate are needed to pass amendments removed from the filibuster maneuver reserved for the main bills.
Ted Muftic's comments on the Supreme Court Decision to allow corporations to advertise their support of issues without restriction
January 21, 2010
Absolutely horrible for our democracy.
Our government will never be the ‘people’s government’ - but will be even more the government of big money with a potential explosion of all kinds of cash into special interest campaigning – from the left and the right.
We are no better than a corrupt third world country when it comes to “bribery” – it may not be explicit and direct under the table stuff..but it is driving pols to make decisions based on how they are going to be able to afford the incredibly, ridiculously rising costs of campaigns. ENOUGH is ENOUGH.
Obama can score points on pushing ethics and campaign finance reform with Independents.
We need to break the link between big money and campaign finance. This would also have the effect of limiting the on-going power of lobbyists who can say “look you won’t get the big support for your campaign costs from our org unless you vote the following way”.
We need to mandate a cap on how much can be spent in a certain campaign and we need to put a defined time limit on how long a certain campaign can last. Just about every country on earth except for ours has this.
And what do we get in our system? a class of professional politicians that are unlike any others on earth. And I don’t mean because they are so great at their jobs, obviously.
Ted Muftic
Ted Muftic on Scott Brown's win in Mass.
Jan. 20, 2010
What I feared about Obama “going big” on legislative agenda has come to pass, despite my overwhelming support for healthcare reform. In this economy, people generally could care less about big social programs and are very focused on their narrow self-interests – like their jobs and their savings. Many normally middle of the road voters have been swayed to think that the health care bill will take something away from them they already have and give it to some poor, irresponsible slob who doesn’t even try to work – most of the times these are viewed as black welfare fraudsters (hence the mix of economic and racial paranoia). They just don’t see how it will benefit them at all and are deeply distrustful of Democrat claims that it will reduce our deficits. These are the “Reagan Democrats” that are jumping off the ship in droves now.
I think the lesson from the Mass. debacle is that the Democrats took their win in 2008 as a “mandate” for their legislative priorities, when, in fact, the independent voters wanted someone to come in and just be “competent” to save the economy and their jobs….We didn’t have a “ mandate”, but our base kept wanting to interpret the election that way.
Also, sorry, but Martha Coakley had no personality and no ability to connect with average folks – nice lady, but not in touch with the community and kind of a cold fish. Voters don’t like the perceived arrogance (John Kerry) or aloofness.
Sadly, heath care bill as it now stands is dead at the doorstep. I don’t’ see any way for the bill to be passed or moved forward until Brown is seated lest the Democrats want to totally wreck any chance of maintaining control of Congress in 2010. It would be suicide.
What a disaster of epic proportions.
Title or topic will be listed as an index in this space:
Oct. 27, 2009: Reading the trial balloons on Afghan policy.
Nov 17, 2009 Employee meeting and small business
Dec. 1, 2009 CBO scoring of the cost of premiumus resulting from the Senate version of the health insurance reform bill
Dec 1, 2009, credit card late fees and payday loans
Dec. 3, 2009 Afghan women and the president's decision
Dec. 3, 2009 AARP supports cuts to Medicare
Dec 4, 2009 Obama's decision on Afghanistan
Dec 6, 2009 Obama's decision making process on Afghanistan surge
Dec. 4, 2009 A local issue: saving the Fraser River
Dec 10, 2009 The senate compromise on health care reform
Dec 13, 2009 Playing with CBO figures
Dec. 19, 2009 Ted Muftic fumes at lobbyist power (see Ted Muftic's insights page)
On Obama and the Nobel Peace Prize
October 9 2009
From the New Testament Mark 6:4...A prophet is not without honor, except in his own country.
The nastiness the radical right and the RNC chair fuming at the news of Pres. Obama's award of the Nobel Peace Prize called to mind that line from the Bible.
Obama may not have gotten all to remove nukes or have gotten the world to turn swords into plough shares in nine months, but he has refocused the world on peace. Those outside our country get it but some in our country do not. Shame on them. Setting peace as a goal and being applauded for it seems to be an anathema to some in our country. Heaven help them.
When George Bush left office, international polls gave him an 11% approval rating; Obama is in the 80's and 90's in the eyes of those abroad. We finally can claim our rightful place as a moral leader in the world. America is baaaaaaack. Felicia
.Impact of legislative proposals on Medicare
October 6, 2009
The Associated Press had an excellent article dated Oct 2. http://news.yahoo.com/s/ap/20091002/ap_on_re_us/us_medicare_seniors per legislation in bills in Congress now.
- In short, those on Medicare Advantage (like me)...20% of seniors, may lose extra benefits like hearing aids and health clubs (I never had those benefits in my plan!) and may have to switch to a different supplemental plan. You and I will still continue to get Medicare benefits
- Preventing illness: 100% for mammograms, diabetes classes and preventive services...and an annual wellness exams...all new.
- More docs will provide Medicare services because of better competition
- more follow up on release from hospitals to make sure you do not return. Hospitals would be penalized for excess readmission rates
- Care coordination so that as you migrate to specialists and back, your care would be better coordinated
- eliminate the drug coverage gap called the doughnut hole. Once a limit is hit now, you are charged the full cost until you qualify for catastrophic coverage
Instead, you would get a 50% discount on brand-name prescriptions and the hole would be eliminated entirely by 2023..
Great summary of health care reform bills and their impact
September 8 2009
The Washington Post has a great summary and answers 8 questions about health care reform:
1. If I don't have health insurance, how will reform affect me
2. If I currently have health insurance, how will reform affect me?
3. How much is reform likely to cost?
4. how much does the federal government now spend on health care?
5. What will happen to small businesses under health care reform?
6. How would a public option or health insurance cooperatives work?
7. What is likely to happen to my Medicare coverage under current proposals?
8. What do the current bills have in common, and what are the major legislative challenges that lie ahead
Go to http://www.washingtonpost.com/wp-srv/special/politics/8-questions/index.html
(copy and paste to browser).More about tort reform, buying insurance across state lines and charitable giving as ineffective solutions to the health care problems
Sept 21 2009
If it is tort reform or buying insurance across state lines, or even breaking up the monopolies of health care insurers, that will be a series of fights that will make the reforms proposed by Sen. Obama look like child’s play. States have traditionally controlled insurance companies and tort related legislation. The most jealous of maintaining states rights have been the conservative oriented states which are also the Republican base. I can just see the insurance companies’ reactions when anti trust legislation or loss of state control of insurers are proposed. The insurance companies will be calling in the chits on their Republican friends. So let’s get real.
Let’s get real in another way: These “alternatives” do some good, but do not resolve the problem of the uninsured, and they are feeble in holding down health care costs. Democrats are open to them all, but they are not blinded by the glint of any silver bullets.
Only fifteen states have not yet passed tort reform legislation; the rest have in some form; we still have a problem with health care insurance costs soaring far faster than the rate of inflation. Will forcing the other fifteen states to pass tort reform really do much in the national scheme of things?
Just which tort reforms will actually lower health care costs to either the consumers or the health care system? We really do not know.There are all kinds of tort reform. Some have to do with capping pain and suffering awards or punitive damages. They do result in the lowering of malpractice premiums doctors pay, but whether those savings are passed on to the health care system, is not known. Some are about methods of settling claims, requiring arbitration before going to court, and circumventing the attorneys’ high percentage take on awards, if not the size of the awards. Those are good for the plaintiffs, but do not necessarily result in cost reduction.
Yes, doctors practice defensive medicine and prescribe some unnecessary tests, but so long as they are liable for any mal practice at all, they will always do so. Do you hear any one wanting to take away patients’ rights to sue or to get compensation for medical practice gone wrong?
Last week, a citizen of
Grand Countywrote the newspaper wondering why charity giving couldn’t solve the problem; why did we have to rely on a government program that would interfere in our lives. I’ll put the “interference” matter on the side for now, but the writer must not have had to look at any medical bills lately. My daughter’s treatment for breast cancer totaled $250,000; my husband’s treatment for a subdural hematoma he suffered in a fall cost $100,000. A couple of those would bankrupt my local church and I hope he donates generously the next time the American Cancer Society or his religious institution knocks on his door.
Medicare: poorly adminstered indeed, thanks to Republicans; Obama seeks to fix it
September 7, 2009
Seniors are freaked their benefits will be lowered. Republicans cut $39 billion in the past 8 years from Medicare trust fund; then they privatized 20% of Medicare with the Medicare advantage program, and the insurance companies who got that contract hiked the charges to the trust fund with administrative costs that were 13% at least (by their own figures) above what it cost for the government to administer to other 80%. Obama seeks to reverse that privatization that soaked the trust fund and will soak the fund $177 billion over the next ten years. Then, Bush did a great one: covered drug costs and did not fund the program, resulting in another hit. The result...90% of the deficit growth in the next ten years is due to both medicaid and medicare. On top of that Medicare is an entitlement program: whether you paid into it enough or anything makes no difference: you get full benefits. It is also based on demographics: that the old folks (baby boomers) are entering the system at a big bulge...and that is another hit...which no one planned for. (stupidity? Shell game?) That is what happened. The Republicans managed not to cut benefits to beneficiaries, but instead, hit the trust fund, causing it to go broke in 2019 and adding to the federal deficit big time.Obama's plan seeks to reverse the privatization that soaked the trust fund and will soak the fund another $177 billion over the next ten years. In addition, the drug companies have pledged to lower drug costs to seniors, which will lower the hit there; and the other is better electronic record keeping which will also help the administrative costs. (Instead of getting a sheaf of paperwork for every little procedure and provider, you will get a monthly statement).All of those savings add up to the $500 billion savings to the admin costs of medicare without reducing benefits. The adminstrative costs are the result of 8 years of abuse by the Republicans..
Where to find independent and unbiased information regarding health insurance reform legislation
Sept 3 2009
I have been asked by many who are trying to sort out health insurance reform legislation from the myths perpetuated by those forces opposed where can one find objective and independent information. I have advised many not to read the 1000 house bill because only a skilled legislator or lobbyists understand the implication of so many passages . There are at least four other bills that have passed or are pending passage. The President next week will give more direction and the White House is working on simplification of the bills. However, if you would like a side-by-side comparison done in lay person's language, I recommend going to the excellent Kaiser Family Foundation site: http://www.kff.org/healthreform/upload/healthreform_sbs_full.pdf,For myth busting, the AARP has just issued a very good piece that 1) busts the myth; 2) tells the origin of the myth 3) summarizes the proposals. http://bulletin.aarp.org/yourhealth/policy/articles/health_care_reform2.2.html?Issues covered:Will the government take over health care so we end up with socialized medicine?Will private insurance be outlawed or wither on the vine?Will the government encourage euthanasia to save costs?Will Medicare be eliminated or gutted to pay for reform?Will the government ration care?
Blowing holes in Republican "alternatives" to Obama care
9/6/09
On the choice, issue: the Republicans say, if you want choice, just go across state lines and choose another plan in another state. That is a very deceptive argument no one has called them on the fact that in 38 of 43 states all are dominated by Blue Cross Blue Shield affiliates or Well Point affiliates. So where's the choice? Going across state lines will only give consumers the same limited choice they have at their state level. Source of data: American Medical Association, "Competition in health Insurance: A comprehensive study of US markets: 2007 update." which I found at Health Care for American Now! web site. (see my web site, www.mufticforum.com for links to resources).Friends, just do not let them get away with this one.I think the Pres. has won the argument on consumer protections; however, the Republicans' keep coming back with "so let's just pass those. Of course, the counter is: cost control. Nothing the R's have ever said keep health insurance companies' administrative costs low. They just want the government to subsidize the same expensive policies they are paying for, or their employers are paying for. The insurance industry must love it: 38,000 new paying accounts, with 11,000 of those subsidized by taxpayers. They should not be allowed into the exchange without some stringent controls on their administrative expenses or else they will be gouging taxpayers and not giving anyone a cheaper choice.The other argument Republicans use is of course defensive medicine, cost of unbridled runaway juries and other tort issues. The hole in that argument is that settlements themselves account for less that 1% of total health care costs...still worthy to consider and do, as Rep.Polis says. The defensive medicine thing falls apart due to so many other reasons so many tests are given in diagnoses. Docs just want to be sure, there are a lot a great expensive tools out there, and Docs do not get rich ordering them because the labs are (or should be) separately owned. The labs get rich, not the Docs. I do not have the figures, but Colorado has tort reform, and I am not aware the number of tests have declined. The answer is to set best practices standards and to reward docs for following them.Felicia.
Will health insurance reform kill capitalism? Lead to single payer system?
9/2/2009
Let us get some perspective here. Capitalism survived Medicare, Medicaid and social security, all at least partially government funded; all are government run. They dictate terms of care far less than private insurers do. Proposed legislation in Congress even formalizes private insurers’ participation so the US will not become England or Canada , which banned competing private insurance.
All plans in Congress enforce maintenance of employer based private health insurance. Even those eligible to buy insurance in the “exchange” , an approved list of plans meeting certain criteria, would have a choice of public or private insurers, with premiums more affordable than the open market. The Congressional Budget Office estimates that only one third of those participating in the exchange would choose the public option (that’s 4% of our total population), hardly enough to torpedo capitalism.
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The value of a public option
9/2/09
One important element of any exchange is to make sure participating private insurers do not gouge taxpayers. Those insurers already ding us with a 13% plus markup for administrative costs . There are two ways to keep those private insurers’ costs under control: either make them compete with the standard set by the public option or cap their administrative costs, charges, and profits by regulations. That is the value of the public option to taxpayers: competition keeps private insurers from taking taxpayers to lunch without the need of having heavier handed regulation . Of course, the value of the public option to consumers is always having a cheaper plan from which to choose.
Note: the exchange is the government run menu of options those who do not have employer insurance or who are otherwise eligible can tap into. To receive a subsidy or a voucher to pay for insurance offered in this plan, eligible recipients will have to buy insurance through the exchange. Subsidies of recipients will be based upon need and income. The purpose of the exchange is to provide a option that is lower in cost than what a person would pay on the open market.
Reading the trial balloons on Afghanistan policy
October 27, 2009
Listening to Kerry this AM, who right now has the best handle on karzai and to Obama yesterday who said he would not send troops there without support from the home front gives me some mixed messages. Trial balloon this AM, we will send less than what McChrystal wants until Karzai shows he is shaping up and flying right. I think I was right to view this dithering as a period of threat to Karzai to get out of the hashish/corruption business
I predict the McChrystal strategy will be geographically limited to either towns or certain provinces and the Biden strategy will be implemented in the tribal areas. Both are valid and I do not see how one can proceed without the other. Enough for my armchair generalling. Politically, neither will satisfy either pure hawks or doves so that Obama is probably either catering to the middle or taking a very big political risk...especially in ticking off the left. However, I do not see the left getting that hot about sending more troops...I certainly am not, but on the other hand, I see myself more a pragmatist of doing whatever it takes wisely to advance our national interests...war is still a legitimate tool. F
Employee meeting in a small business- Nov 17 2009
I have received several viral emails lately describing a fictitious emloyees meeting at a car dealership that laid out the horrors the Obama administration policies will cause small business. Here is my answer:
Since the health billing funding mechanism has not yet been determined, and recent polls show 65% of the public supporting taxing the very rich to pay for health care vs.cadillac plans, I think much of this is premature.
I will, however, note that I spent over 12 years working for a car dealer...doing his charitable giving and community outreach and know the hard times car dealers have gone through. No more charity; no more employment...and likewise many of the employees were let go. This is partially directly related to the Bush financial policies and the failure of the auto industry to adjust to the changing times. I also know that most sales staff were there on commission and part time. It is exactly that group that does not have access to health insurance...lower middle class income....part time folks...who will benefit by access to affordable health care.
I also know that my small business car dealer benefitted greatly by the cash for clunkers program and it probably kept his three GM dealership doors open until business has begun to pick up.
I am heartened by the favorable rates extended to community banks and the Treasury providing $700 billion financial resuce funds provided them. This is where 65% of jobs are created. The fortifying of the SBA is also welcomed...and, full disclosure, my family business runs and depends on SBA loans. The Republican party in the past has a track record with SBA that is deplorable, underfunding and under emphasizing. I have watched what damage it has done to regional offices and the demoralizing of its efforts under the Bush administration.
If the Republican party had its way, small business would not have access to stimulus funds. Tax reductions are nice but with no ability to borrow to expand, they have their limits.
There are winners; there are losers...so keep that in mind...and I see the winners for small business under Obama and the past track record of Republicans regarding SBA and their refusal to vote for the stimulus would have been a distinct loser.
It seems like the only time the Republican party cares about small business is when it suits them as a political issue.
Only 5% of small business will be subject to requirements to provide either a penalty or health insurance to its employees. The rest, 95%, will not have to provide insurance and can refer their employees to the government program..so that burden will be lifted from the backs of small business and their owners. Also, small business will be allowed to enter into large group plans.
Impact of Senate bill on insurance premiums
Dec. 1, 2009Dec 1, 2009
The Congressional Budget Office released a study of the imact on insurance premiums of the Senate health reform bill now being debatd on the floor of the Senate. For those who buy insurance on their own, when one factors in the subsidies for the 31 million in the exchange, their costs would be 56 to 58% lower on the average. For those who buy insurance through a large group such as through an employer, there would be not substantial change. Those who buy through small groups, such as small business, would see a reduction.
These figures are average per each group, but some will see an increase: young and healthy. Also, young and healthy would be required to have insurance, even some who do not carry insurance now would have to buy it. There will be a decrease in premiums to older and sicker folks.
These figures are expressed in percentages. However, all premiums will rise by 2016 anyway due to inflation.
For the full report, see www.cbo.gov and look for the report dated Nov 30
For a summary, see the New York Times Dec 2, 2009
Credit card late fees and payday loans
Afghan women and the president's decision
Dec. 3, 2009
I am saddened that Obama’s goals include working with the Taliban to bring them to “our side” since they will be free to impose and extend their medieval rules on women’s rights . I am sorry for the women of Afghanistan, but I do not believe our country has the will, heart or money to remain as occupiers with sufficient resources long enough to change that culture. President Obama clearly implied that the role of NATO and US troops was to dismantle and destroy Al Qaeda and to keep them from reestablishing a base of operation in Taliban controlled areas. It was not to occupy or to change the Afghan culture.
AARP SUPPORTS CUTS IN MEDICARE
DEC 3, 2009
From the Dec 1 AARP Bulletin (www.aarp.org)
Congressional health care reform proposals, after months of wrangling, have been distilled into two major bills, one in the House and one in the Senate. The bills differ in some areas—such as the amount and kinds of taxes they would levy to help finance reforms—but there is little overall difference in the measures when it comes to the critical question of trimming Medicare costs. The bills would carve $420 billion to $440 billion in savings from the program, but the savings would not affect traditional Medicare benefits. In fact, budget experts say, without cutting guaranteed benefits, both bills shore up the solvency of the Medicare trust fund for five additional years.
Indeed, experts generally say reform legislation—the House approved its bill in November, the Senate will begin debate on its final measure this week—aims to strengthen Medicare and improve beneficiaries’ care and access to physicians. The proposals even add new benefits; for example, making preventive measures such as mammograms and colonoscopies free to beneficiaries, and improving prescription drug coverage. Still, fears among Medicare beneficiaries remain.
“Medicare beneficiaries are the most satisfied of any Americans with their health coverage, so it’s natural for them to worry about any changes that might alter it, especially when they’re being lied to in a deliberate attempt to make them feel anxious,” says Jonathan Oberlander, a professor of social medicine and health policy at the University of North Carolina, Chapel Hill, and author of The Political Life of Medicare.
Today, older Americans on Medicare “have an incredibly valuable security blanket,” says Joe Baker, president of the Medicare Rights Center, a nonprofit consumer service organization. “So once you start rocking that boat, they react viscerally. But I think if you don’t scare them, seniors view reform more positively. They’d love for their children and grandchildren to have the same sense of security that they have now.”
But how can billions of dollars be carved out of Medicare to help pay for reform measures without affecting traditional benefits? And what’s the outlook if no action is taken?
Medicare’s future without reforms
Often missing from the public conversation is what happens to Medicare if nothing is done. If Medicare’s expenditures exceed its income—which for the hospital side of the program is projected to happen as early as 2017—the only way it could then get out of the hole would be to raise payroll taxes, reduce benefits, increase enrollees’ share of the costs or enact a combination of all three.
If nothing is done, beneficiaries’ out-of-pocket Medicare expenses will eat up an increasing part of their Social Security checks, according to the 2009 Medicare trustees’ report.
“So we do need to make some changes in the program … [and] we need to start now,” says Mark McClellan, who ran Medicare as head of the Centers for Medicare & Medicaid Services under the administration of President George W. Bush. “The best way to keep benefits secure and keep health care costs down for seniors is not to be afraid to take some steps to improve this program,” he says. “It’s not about saving money itself. It’s really about making the program better.”
How to save billions without cutting traditional benefits
Both the House bill (HR 3962) and the Senate leadership bill (HR 3590) include $420 billion to $480 billion in savings carved from future growth in Medicare spending over a 10-year period. Although that sounds like a huge sum, it’s actually only a small fraction—3 percent—of the $6.4 trillion expected to be spent on Medicare from 2009 to 2019.
The savings are expected to be achieved mainly by:
• reducing fraud and waste through improved oversight;
• reducing government subsidies to private Medicare Advantage plans;
• paying doctors more for practices that improve quality of care and save money;
• providing incentives for hospitals to reduce costly readmissions and protect against hospital-inquired infections;
• setting up a Medicare commission to authorize cost savings (Senate bill) and (in the House bill) allowing federal officials to negotiate lower drug prices for Medicare;
• paying providers (notably hospitals and home health agencies) a little less of an increase each year in an effort to gradually trim the rate at which Medicare costs climb over time—aka “bending the cost curve.”
“These are not reductions in benefits; they’re not even reductions in the prices that Medicare pays. It’s a slowdown in the increases in prices,” says McClellan, the former Bush administration official, who now heads the Engelberg Center for Health Care Reform at the Brookings Institution in Washington.
Increasing the quality of care while saving money sounds like a tall order. Yet a number of leading medical centers have shown it can be done. So has Medicare. In Medicare’s recent incentive-payment pilot programs across the country, physician groups received incentive payments for meeting standards that improved the care of patients with diabetes, heart disease and cancer. In one year, five groups alone generated $32.3 million in savings to Medicare, because better care reduced the expense of complications, unnecessary tests and hospital readmissions.
“These steps are win-win,” McClellan says. “It’s not about squeezing money out of Medicare and putting it somewhere else in health reform. It’s about changing the way we pay so that we all [government and beneficiaries] get more for the dollars we spend.”
Slowing down overall Medicare spending is directly in beneficiaries’ own interests, Oberlander says: “If they’re paying 20 percent of the costs, and that bill keeps going up and up, the burden on them is really going to become too much.”
Reducing subsidies to Medicare Advantage plans
Cutting government subsidies to private Medicare Advantage plans, in which just under 25 percent of beneficiaries (10.4 million) are enrolled, is far more controversial. Medicare currently pays an average of 14 percent more for people in these plans—about $1,100 more a year per person—than for those enrolled in the traditional Medicare program. And the latter actually contribute to the higher subsidies through their Part B premiums.
The subsidies allow the plans to offer extra benefits and lower costs, which attract beneficiaries to enroll. But those “enhanced benefits are funded by the taxpayers and all beneficiaries,” according to the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare finances. “This added cost contributes to the worsening long-range financial sustainability of the Medicare program,” the MedPAC said in a 2009 report. It added that a portion of the subsidy is “used for plan administration and profits and not direct health care services for beneficiaries.”
Under the House bill, these higher payments would end by 2013, saving an estimated $172 billion over 10 years. The Senate bill would use similar measures to save $118 billion over a decade, according to the Congressional Budget Office. If that happens, Medicare Advantage plans could cut the extra benefits they now provide to enrollees, raise their costs or withdraw from Medicare. Or the plans could become more efficient or accept less profit. The bill also provides bonus money to the plans for quality results.
AARP supports cutting the plans’ higher payments, even though AARP Services Inc. endorses a Medicare Advantage plan. “Gradually eliminating these excess payments will permit good plans to continue and put pressure on others to offer better value to their enrollees,” says John Rother, AARP’s executive vice president of policy. “That’s what fair competition is supposed to do.”
Patricia Barry is a senior editor of the AARP Bulletin who covers Medicare and health policy issues.
Obama's decision on Afghanistan
Dec 4, 2009
Obama's review of the situation was reassuring, not a symbol of any weakness or panic and I am glad he did it.At least he is doing the surge with his eyes wide open, unlike his predecessors....who first declared the policy and then tried to find the justification. The one time GW Bush gave thought to a policy, it took 4 months, and he approved the surge that was a success in Iraq.
Obama's approach is a pragmatic approach, not an a priori approach. The other unspoken factor is that the country is tired of war, wants attention paid to the economy, jobs etc and if the Pew poll is correct, is turning isolationist. Frankly, for the President to do what he did is an act of courage in the face of voters on both sides of the spectrum wished he had decided otherwise.
The response from NATO and Japan have been better than I would have expected and is a tribute to the renewed stature of the US in foreign affairs in the wake of Bush's disaster. Today NATO announced 7000 more troopes for Afghanistan from 12 countries. Since much of what the mission is about is training and not so much combat. This brings the total of troops to arounce 37,000, very close to McChrystal's request. In addition, Japan's pledge of $5 billion for economic development is also welcome, since it
means that is $5 billion less the US taxpayers have to cough up.Obama's decision making process on Afghan surge
Dec. 6, 2009
read Dec. 6, 2009 New York Times article "How Obama Came to Plan for 'surge' in Afghanistan
Due to copyrights I cannot reproduce it, but given the gravity of the decision, Obama can at least rest in peace he gave it very thorough consideration...The following is not a summary of the article but my reaction to it and some of the contents:
His first reaction to McChrystal's request was "no", but he changed his mind when he questioned the entire premise of our involvement and listened to every possible point of view. Key was the fear a prolonged involvement would be so expensive, it would wreck his domestic agenda, the intelligence reports and the repercussions of abandonement or loss that would allow Al Qaeda to resurge and that Al Qaeda still posed a major threat to the US, and his visits to Arlington Cemetary and Walter Reed, visiting the wounded. He settled on a quick entry and exit strategy preparing the Afghans to take care of their own security. The time line was his doing, but he made sure that it was contingent on the conditions on the ground. For Hawks who accused him of dithering, if he had made the decision quickly, we would not be seeing a surge in our future. For doves, he has formulated a plan to get us out that may work. FeliciaSaving the Fraser River
Dec 4 2009
This is a letter to the editor that I thought deserved preservation for a while, so I have copied it from the Dec 4 edition of the Sky Hi Daily News onto the blog:
To the Editor:
I live about one mile from the Fraser River. I have also served as a volunteer with the Colorado Division of Wildlife helping count fish in that river. I have seen first-hand the effects of diverting water from the Fraser.
I often daydream about what the Fraser River must have been like when President Eisenhower fished these rivers over fifty years ago. The river we have now certainly would not have lured him all the way from the White House to fish here today. Sometimes there is so little water in the river that it barely seems to be a river at all. It is struggling for its life. I was surprised to read that it was the third most endangered river in the country, but on second thought I guess that I was not totally shocked.
It does not require a scientific study to prove that taking more water from the Fraser would cause environmental damage to the river and therefore our ecosystem. The damage is already pretty obvious even with the current levels of diverted water. Taking more water and expecting no more damage defies logic. That is what the current Environmental Impact Study (EIS) for the Moffat Firming Project would have us believe, but it is just not believable on any level.
The current draft of the EIS does not even mention the importance of high water flows in the spring. These flushing flows are absolutely essential to the vitality of the river. High water flows also shape and clean the streambed so that fish and fish food can survive. The issue of environmental damage must be addressed. This is not rocket science, it is common sense.
I think it is time to ask what water rights Denver Water really has, and it needs to be considered at a fundamental level. When these rights were created 100 to 150 years ago, they envisioned that the water would be removed from the rivers or streams, used and then eventually returned to the river or stream that it was taken from.
Denver Water currently uses these rights in an entirely different way. The water is removed from the waterways, used and never returned. They are taken from one side of the Continental Divide and diverted for use to the other side of the continental divide. By definition, the water can never be returned to its original environment. Have these rights been vetted by a court of law from this perspective? It is time to address that question?
One way to give the Western Slope some time to recover and to plan for the future would be for Denver Water to address conservation of the water that they already have diverted. The conservation efforts to date have not addressed the impact of outdoor water use. The watering of plants and grasses uses a tremendous amount of water to keep them alive in the high plains desert of the Denver area.
It has been estimated that a significant percentage of the of the predicted water shortfall for the Denver area could be met by simply not watering plants, like Kentucky Bluegrass and others, that were not meant to survive in a desert. The very least that Denver Water could do is to make conservation of water a first priority, and make diversion of more water from the Western Slope a last priority.
The Moffat Firming Project cannot be considered in a vacuum. At the very same time that Denver Water is proposing diversion of more water from the Fraser River, the Northern Water Conservancy plans to divert more water from the upper Colorado River. Denver Water's EIS does not even acknowledge that fact. If these projects are not considered together, the combined impact of the two projects could be devastating to the native flows of the Colorado River.
There is hardly any mention of the mitigation plans to address the impacts of reducing the water flows of the Western Slope in the EIS. There must be a mitigation plan in place before any more water is taken. We are not just talking about the survival of our rivers, but the survival of our ecosystem, our economy and our way of life. Counting on the tears of all us who live on the Western Slope to replenish the lost water is not a sufficient plan for mitigation.
Steve Radcliffe
FraserThe Senate Compromise on health care reform
December 10, 2009
Just when you think you have a handle on the medical care reform proposals, the Senate gives you Mr. Toad’s Wild Ride. The compromise reached in Sen. Majority leader Harry Reid’s off ice last week did not resemble what came from the committees or what was proposed as a bill moving forward. To take a phrase from one of my favorite TV commercials, “this is a whole new animal”. At least, it is a new animal in part, the part pertaining to the contentious public option.
The reason for the upheaval: there were just not enough votes to pass reform with a bill that included a public option, opted in, opted out, though it may happen the public option trigger compromise lives on. While progressives may bemoan the demise of the public option, the substitute just is not that bad. Even then, a triggered public option may lurk in the legislation like cavalry held back behind a hill in case the infantry charge fails.
Here is the essence of the compromise: Several national insurance policies administered by private companies would be administered by the same office that oversees health policies for federal workers. Those who would have access to this federal program would be similar to the ones granted access to the now defunct public option, though the press reports I have read do not address this. Subsidies would be given to those who could not afford premiums, as in the original version, though it may be extended to those who are 150% of poverty level instead of 135%. The fees would be negotiated by the Office of Personnel Management, just as they do now for federal employees, and if negotiations would fail to produce acceptable policies, a public plan could be created that would provide an acceptable alternative. This is the trigger version, but whether it survives the floor vote is not yet known for sure.
In addition, access to Medicare would be lowered to allow those 55 and older (instead of 65 now) to join in and pay for insurance. This was the sop thrown to progressives, but it might prove to be a politically popular one. Medicare is a single payer government program that even conservatives like. I do recall the tea party/town hall meeting posters waived by angry seniors who demanded that government does not take away their Medicare, obviously unaware that Medicare was a government entitlement program funded in part by taxpayer money. Of course, Medicare’s finances are shaky, but by bringing in paying younger folks, the Medicare financial situation could be greatly improved, since the real drain on Medicare are the older patients, who need intensive end of life expensive care.
What about Obama’s promises for a public option? Has he gone back on his word? Reality check: President Obama originally never proposed the public option. During the campaign he advocated giving Americans the same access to affordable insurance that members of Congress had and that is exactly what came out of the compromise last week.
The only difference is that only 31 million will have access to this federal employee program; the rest who have employer provided insurance will not.
Will this lower health care costs and give the insurance monopolies competition? One provision in the compromise has me cheering: all insurance companies would be held to administrative costs of 10%. We insurance premium payers have been donating 20 to 30% of our premium payments to cover our carriers lobbying, high salaries, and advertising. The compromise requires insurers to devote 90% of premiums to actual delivery of care services. This should reduce premiums to everyone.
Competition? The federal employees plan would negotiate the private insurers’ rates. In short, they would be setting a standard by which those not in the plan could compare their employers’ plans and demand equal treatment.
Yet to be seen is the cost of this compromise and the Congressional Budget Office will “score” it to see if it keeps within Obama’s guidelines of $900 billion over ten years in order to reduce the national debt, as measured in cost to the gross domestic product. The House and previous Senate versions would have reduced the debt from $113 billion to $130 billion. Republican alternative plans would only have scored a $64 billion reduction.
In the meantime, the Republicans in Congress have become obsolete, removing themselves from any participation by just saying no and fighting any element that would extend accessible insurance coverage to the uninsured and uninsurable. With a mean spirit, all of their alternative proposals would fail to cover any significant number of the currently uninsured.. The fact show that that 44, 000 people die each year because they lack insurance, is just not an issue with them. What appears as a priority for Republicans is to protect the insurance companies’ high profit and administration overhead under the ideological banner of advocacy for small government.
Playing with CBO figures
Dec 13, 2009
the source with the most credibility is the Congressional Budget Office. This is the non partisan bunch of numbers crunchers. They are the ones who analyze costs and savings of various bills for members of Congress. Not only is the CBO recognized as authoritative and non partisan, it is what members of Congress ultimately base their decisions upon.
What politicians, pressure groups, and special interests do with those CBO figures is the problem. There are commercials, Senators, and Congress members using CBO figures in very imaginative ways in the current health care debate regarding several issues: 1) the impact on Medicare, 2) impact on the cost of insurance premiums, and 3) Cost of the Democrat’s bills. The charges and counter charges can sound so confusing and contradictory, that it is difficult to find who is and who is not telling the truth.
AARP supports the reform bills because they do not affect traditional Medicare benefits and they shore up the solvency of the Medicare trust fund for five additional years. The bills even add new benefits; for example, making preventive measures such as mammograms and colonoscopies free to beneficiaries, and improving prescription drug coverage. Cost reductions would result from measures for reducing fraud and providing incentives for hospitals to reduce readmissions and reducing government subsidies to private Medicare Advantage plan, with which the AARP agrees.
One trick is to take CBO figures and draw conclusions the CBO does not draw. No doubt yout havre heard Sen. Gregg Judd (R-NH) peg the cost of the Democrat’s reform bill at over 2.5 trillion dollars. Democrats , CBO and the president use the figure of 849,billion. Is someone lying?
Sen. Judd is playing a numbers game: he is counting cuts in Medicare spending as a cost added, not a cost reduction. That kind of bookkeeping would give my accountant fits. He adjusts the time frame of his estimates so that they do not coincide with the CBO time frames, adds tax hikes to pay for the plan as a cost (maybe to upper income folks, Sen Gregg, but not to the federal government), and says that `higher insurance premiums would result, calling that a cost, as well.
The CBO later responded that the reform bill would cause premiums costs to go down, not up, on the average. For those who buy insurance on their own, when one factors in the subsidies, their costs would be 56 to 58% lower on the average. For those who buy insurance through a large group, there would be no substantial change. Those who buy through small groups, such as small business, would see a reduction. However, all premiums will rise by 2016 anyway due to inflation, but that is not the fault of the reform bill.
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Winter Park, CO 80482
ph: 303 810 0809
feliciam
In my former life, as an executive with Consumer Credit Counseling Service, I was the consumer lobbyists working to keep local Colorado credit card issuers from scamming consumers with high late fees. The bill passed, if I recall, but most credit cards are now issued nationally, so that whatever is done on the state level to control this is not useful. It must be done by federal legislation. A bill to protect consumers to some extent was passed through Congress lately, but does not take effect until early Winter 2010. In the meantime the credit industry has been raising rates and taking advantage of the delay in implementation to an outrageous degree. A bill was introduced in Congress to stop this behavior, but has been fought tooth and nail by Republicans and is now still pending, the last I heard. Felicia