How Health Care Reform Efforts May Affect You (Corrected)

This was published yesterday with a different headline and slightly different text. Today I also changed the phrase “local and state” to “state and federal.”

Last week the Federal Centers for Medicare and Medicaid Services (CMS) reported that health care spending was 17 percent of the U.S. economy last year. By 2012, according to the report, state and federal governments will pick up more than half the tab. The recession has increased the number of people who qualify for state-funded Medicaid. As baby boomers retire, the Medicare rolls will swell.

Most people agree that health care reform is not an option. This video includes interviews with business leaders who support as well as those who oppose the current health care bills. Please watch, listen, and contact your legislators to share your opinion.

Welcome back. Don't forget to subscribe if you haven't done so already. Come back again.



Bredesen Could be HHS Secretary – CORRECTED

Updated 2/11/09

The rumor mill is circulating with possible names for the new Secretary of Health and Human Services (HHS). Among those names is Tennessee’s Democratic governor, Phil Bredesen. Despite what Republican opponents and MoveOn.org say about the matter, he would be an excellent choice.

Bredesen knows what it’s like to insure a large population of unhealthy people who have low incomes. He understands the needs, and he has found a way to provide coverage with little support from the federal government and much opposition from state Republicans and idealistic health advocates.

When faced with cutting scores of chronically-ill patients from the rolls of TennCare, the state plan for the poor and uninsurable, Bredesen flew to Washington more than once. The past administration denied his repeated requests for changes to the Medicaid waiver that covered the plan.

Around that time, some Republican candidates for the state legislature openly campaigned and won seats on a platform of reforming the plan. They claimed it was rife with fraud and blocked Bredesen’s efforts to change and save it. The office that investigates such matters has since found little evidence to support those claims.

Republicans and health care advocates, who didn’t understand the big picture and refused to compromise, then smeared Bredesen’s name in the press and blamed him for the cuts when voters who lost their coverage became angry. But Bredesen was faced with competing challenges. He faced those challenges as total federal contributions to the state budget decreased.

Health care costs in Tennessee were taking money that was needed for education and other priorities. Bredesen understood that a person with a good education could afford private insurance or get one of the few jobs that still offered a group plan. He used the money he saved to expand pre-kindergarten programs in the state.

He also understands that education is important because the good jobs of today require highly-skilled workers. Having more workers with good jobs expands the tax base that is needed to support vital services and lowers the tax burden for all.

Tennessee has lost many of the manufacturing jobs that supported middle class families in the last few decades. Most of those jobs have been replaced with low-paying jobs in the service and retail sectors that don’t offer health insurance.

Governor Bredesen has personally experienced the high cost of not having insurance. His own brother died because he was uninsured. Since then, Bredesen has created a plan to cover the people who were cut from TennCare with a combination of public and private funds. Additional plans cover small businesses, children, and those who have lost their jobs.

Before the current economic crisis, Bredesen did all these things with a balanced budget and without raising taxes. Like everywhere else, sales and property tax revenues have plummeted.

Tennessee also doesn’t have a state income tax. Republicans almost incited a riot the last time Democrats tried to enact one.

Republicans once again distorted these and other facts and took advantage of low information voters (LIVs) to gain control of the state Senate in the last election. They are one vote short of controlling the House. Republican Deputy Speaker of the House Steve McDaniel has openly admitted that funding services in the current situation will be the most challenging task he has faced in his entire tenure in the legislature, and he doesn’t know where to start.

Governor Bredesen deserves the nomination. He’s a big boy who knows how to get the job done in a hostile political climate like the one in Washington.

An earlier report stated that Republican Tennessee State Senator Steve McDaniel was Speaker Pro Tem. He is Deputy Speaker of the House, and soon may be named temporary speaker. The speaker, Independent Kent Williams, is away tending to his sick mother, and the Speaker Pro Tem, Democrat Lois DeBerry, is recovering from an unspecified illness.

—-

Jacqueline Laurette Jones is author of Unmasking a Diagnosis: How to get Help for a Confusing Chronic Illness Without Filing for Bankruptcy.

Bill Promotes Economic, Physical Health for All

I never knew public policy could be so much fun. The summary of the American Recovery and Reinvestment Bill of 2009 that passed the House of Representatives is more exciting than any of my favorite movies.

This bill shows an amazing grasp of the complexities of the current economic crisis. It addresses immediate needs and makes a down payment on long term goals while reducing the stresses that can lead to chronic illness and higher health care costs in the future.

Implementation of this bill could substantially reduce entitlement spending in several areas and reduce the burden for all taxpayers by addressing the following issues:

  • The increases in food stamps and food services for the elderly will promote better nutrition to reduce health care costs
  • Vocational rehabilitation and public service opportunities will allow the disabled and the able seniors to reduce their reliance on public aid
  • Increases in unemployment insurance, Medicaid, and COBRA insurance for those who have lost their jobs will help them meet basic needs, maintain their health, reduce costs associated with advanced stages of disease that result from lack of treatment, and preserve some jobs in the retail and health care sectors
  • Funds for job retraining, work study, Pell grants, and research will prepare the country and its citizens for the jobs of the future
  • Infrastructure projects and loans will create new businesses and help existing ones retain current employees and hire displaced workers from the housing and auto industries and other sectors who have transferable skills
  • Green jobs will create a healthier environment and reduce the pollution that contributes to chronic disease while reducing the need for assistance with energy bills
  • When basic opportunities are available and basic needs are met, expenses for the criminal justice system are reduced.
  • Funds to train primary care workers will avert the consequences of a shortage when they will be needed to provide care that reduces the cost of chronic diseases
  • When basic opportunities are available for the strong and basic needs are provided for the weak, fewer people enter the criminal justice system and related expenses are reduced

The bill reduces waste by utilizing public and non-profit organizations that are experienced in meeting the challenges we face and have accountability procedures in place. It also preserves jobs in those sectors and provides protection for whistleblowers who wish to report fraudulent use of taxpayer dollars.

By providing economic opportunities for a broader cross-section of society, this bill can broaden the tax base, help reduce chronic illness, and reduce dependence on entitlement programs. That can lower the tax burden for all if coupled with a more judicious use of military force. The financial sector will only return to health when the people can afford their services.

The Republican response to the bill is an example of why they don’t need to be in charge of the country’s business anytime soon. Their ideas are based on the myth that everyone can pull themselves up from their bootstraps. They don’t understand the impact of unfair public policy on average citizens. Unless they gain an understanding of the issues that face common people, they will remain the party of a vanishing breed: people who are actually thriving under their policies.

—-

Jacqueline Laurette Jones is author of Unmasking a Diagnosis: How to get Help for a Confusing Chronic Illness Without Filing for Bankruptcy.

Economic Health Requires Revolutionary Change (Part 1)

Corrected 11/19/08

Most people in America understand that radical change is overdue in this country. The votes they cast in the last election signaled this basic understanding. Few people who cast those votes understand how much change is needed to save the U.S. economy and economies around the world.

Low wages don’t leave room in family budgets for health care expenses. Inflexible work schedules and long hours don’t leave time for workers to do what it takes to prevent disease. The resulting chronic illnesses make workers less productive and increase health care costs for employers.

Employers reduce expenses by slashing some jobs, moving others to foreign countries, and cutting work hours for remaining employees. That leaves employees without the means to pay for retraining programs that can prepare them to find better jobs. They stop making payments on second mortgages and credit cards that have helped them live beyond their means.

Unemployed and underemployed workers apply for public assistance as the tax base that pays for the assistance shrinks. People who once supported non-profit agencies that help the needy now seek help from those agencies. The agencies must turn people away.

Next add to the mix students who have borrowed heavily to prepare for jobs that aren’t there and now can’t repay their loans. This leaves lenders reluctant to lend money to anyone. Businesses that depend upon credit lay off more workers or close their doors. Tax revenues decrease even more, which leads government officials to slash budgets and lay off still more workers.

The list of people who have been reduced to buying just necessities, when they can afford them, is growing daily. When we stop buying, people in other countries who grow or manufacture many of the goods we used to buy make less money. They, in turn, purchase fewer products from us.

The country has not faced this many challenges since the American Revolution, says Nouriel Roubini, Associate Professor of Economics at New York University’s Stern School of Business and former adviser to the U.S. Treasury Department.

In a consumer-driven society, there can be no stability on Wall Street without stability on Main Street. In spite of this fact, most of the aid in this economic crisis has been directed toward the financial services industry. The new man in town promised to change all that, and the people voted to let him try.

Reports are circulating that President-elect Obama’s advisers are weighing the political consequences of pushing incremental versus rapid changes. In a democratic society, the people must be willing to come along for the ride, but they will only continue the journey if they see results.

Effective solutions will involve careful planning that addresses short-term, intermediate, and long-term needs. Here are my suggestions for the next phase of the new American Revolution:

Meet again with lenders to develop and enforce a mandatory plan for restructuring mortgages. The new loans should be closer to 30 percent of an applicant’s available income. That was the accepted standard before the housing crisis began. The plan announced earlier this week will allow buyers to pay up to 38 percent of income. It also reduces the lending rate for only five years before it begins to slowly climb again. Both Sheila Bair, chairman of the Federal Deposit Insurance Corporation (FDIC), and Bruce Marks, head of the Neighborhood Assistance Corporation of America (NACA), have said the new plan is not good enough.

Rewrite new mortgages to include penalties for anyone who abandons a home. Some mortgages include “no recourse” provisions. Many lenders are waiting for a government bailout, and more people are shirking their responsibilities every day. The government can’t continue to reward bad behavior.  City and state officials also need to know how much tax revenue they will have to meet their obligations.

Recognize that we have a housing crisis, not a mortgage crisis. Allan Meltzer, economist and professor of Political Economy at Carnegie Mellon University, says housing prices won’t stop falling and credit won’t ease until the excess supply of homes decreases and the balance sheets at financial institutions stop shrinking. Meltzer proposes a tax credit through the end of next year for those who purchase homes that have already been foreclosed. This move will kick start the slumping construction industry as well.

Merge General Motors with one of the other “big three” automakers, then allow the remaining companies to reorganize under bankruptcy protection. This idea came from both Bill Ackman, CEO of hedge fund management company Pershing Square Capital Management, and Joseph Stiglitz, a Nobel Prize winning economist and professor. U.S. automakers aren’t prepared to meet the challenges of today or those of tomorrow. Bankruptcy will force them to develop long-range strategies.

Recognize that we have a service-based economy. Our economy is imploding because we have forgotten a basic principle of good business–find a need and fill it. Low-, medium-, and high-skilled workers are needed in all areas. Craftsmen, accountants, educators, writers and editors, engineers, and people with other transferable skills are essential.

Move displaced workers into similar jobs rebuilding the infrastructure and building a “green economy.” Infrastructure projects can build and repair roads and bridges and expand public transportation. Overlap them with public and private “green” construction projects that rebuild communities affected by disasters. Retrofit buildings that don’t meet energy efficiency standards. By doubling our current rate of recycling, including waste from these construction projects, we could replace almost every job that has been lost this year. Pulitzer Prize-winning journalist, author, and columnist Thomas L. Friedman says “green” projects can employ workers with diverse skills.

Subsidize or give tax credits to organizations that hire displaced workers. Those who move into related positions may even be able to start immediately and train on the job. Workers who have good jobs are less dependent upon government assistance and can afford to stay healthy.

Without changing the policies that created this mess, we will not see the end of the downward spiral or avoid creating another one. My next post will address strategies for making intermediate and long-term changes that address both domestic and foreign policy issues.

The second sentence in the eighth paragraph has been corrected to end with financial services industry instead of businesses. The word occupants has been changed to anyone in the first sentence of the twelfth paragraph.

—-

Jacqueline Laurette Jones is author of Unmasking a Diagnosis: How to get Help for a Confusing Chronic Illness Without Filing for Bankruptcy.

Relief for Doctors and Patients is on the Way

My last post addressed how time constraints and other problems in the medical system interfere with a physician’s ability to provide good service. Last week The New York Times reported that an influential nonprofit organization focused on health care has proposed changes to relieve some of the pressure.

[Read more...]

Disease Care Wastes Money and Lives

We buried my aunt last Saturday as another group of relatives gathered in a different city to bury her best friend, a cousin, at the same hour. They were two victims of chronic illness, and both had access to medical care. My aunt received treatment at one of the best medical centers in the country. I don’t know the specifics of the cousin’s care.

[Read more...]