Why I Was Gone

I've been unable to post a blog because my Internet Provider went down right after the July 5 post. I'll continue where I left off in the morning. Thank you for your patience. 

Obama Care Chatter

A few years ago Mitt Romney said Justice Roberts was a model of the type of person he’d appoint to the Supreme Court but now he and other Republicans are disappointed in the ruling of June 28, 2012. Although the President’s health care law is similar to what Romney enacted in Massachusetts (included fines for those that didn’t buy insurance), Romney said it was bad law and policy and on his first day in office he’d begin to repeal it; Obama Care will cost jobs as businesses can’t afford the costs; it raises taxes by $500 billion and reduces Medicare by $500 billion and it will increase the country’s deficit. George Stephanopoulos said a repeal of the law was doubtful; he could with an Executive Order allow states to opt out of exchanges, delay implementation and/or not fund the subsidies (expansion). On June 27, I heard a small business man say the mandate to insure employees will tie up company funds and keep them from hiring new employees and growing their businesses; this supports my belief that the cost will eat into profits and they choose profits over people; I say small similar businesses can merge, become more efficient and still grow which would lead to new hires. Romney in his response failed to say that the tax increase is not on the average American and any increase in the deficit would only occur if Republicans continue to fight the elimination of the Bush tax cuts for the rich which is much more than what he said health insurance will cost taxpayers. Romney did agree that the cost of health care must be reduced but failed to say what more could be done (see my January 16, 2012 - Health Care, February 20 - Life & the Government, February 27 thru 29 - US Medical, Parts 1-3 and May 31 - Health Care Madness blogs). I want to point out that on June 20 ABC reported that 100,000 Americans die every year because of hospital errors or problems and a study by the Leapfrog Group identified the safest hospitals in the US. Interestingly Massachusetts was number one (Maine, Vermont, Illinois and Tennessee were next). I went to the Leapfrog Group’s websites and found that they said – “If the first 3 patient safety practices were implemented in every non-rural hospital in the US over 57,000 lives could be saved, as many as 3 million serious medication errors could be prevented and close to $12.0 billion could be saved each year”. I also discovered that not all hospitals participate in the Leapfrog studies, the www.leapfroggroup.org/cp website displays the 2011 results from March 28 – July 25; the 2012 results would be posted at the end of July and you can find your hospital’s rating on hospitalsafetyscore.org/. In addition to the savings identified in my blogs and by the Leapfrog Group, no one has calculated the savings due to eliminating bankruptcies caused by medical bills or the reduction of emergency room care for the uninsured.  

The President said the Court’s decision allows 250 million Americans to keep their health insurance; allows for it to be more secure and affordable; insurance companies can no longer drop coverage when you get sick or jack up the premiums without reason; they won’t be able to charge women more than men; they must cover preventive care and some Americans will get rebates from their insurance companies because too much money was spent on administrative costs and CEO bonuses. The President said he did it because it was the right thing to do and not because it was politically correct. A poll showed 52% of Americans disapprove of the law. I think the average American doesn’t understand what is gained and Republicans have twisted the truth (Boehner said the people don’t want the government telling them what insurance to buy or how much to spend – this is not the case).

The Court decision said the government can’t force people to buy insurance but it can tax them more if they don’t. Beginning in 2014 an adult would pay $95 more in taxes, a family $285, and in 2016 an adult would pay $695 and a family $2085. The Tea Party and Justice Scalia argued that you start with health insurance and then you force people to buy broccoli; the decision shot down this argument – the government can’t force you to buy something but it can tax you more if you don’t – we already tax cigarettes, alcohol and gas guzzlers more.

On July 1 Jack Lew, the White House Chief of Staff, said Americans who can’t afford to buy health insurance can get it through a government program, there’s a tax cut of $4,000 for people needing help paying for insurance, those that are taxed will be the 1% that can afford it and choose not to buy it and spread the cost to all others (example: emergency room costs). Per George Stephanopoulos the Court said the feds can’t reduce funding to States that choose not to expand their Medicaid programs (including coverage) and it could affect 14 million people; per Lew the expansion is 100% federally funded until it drops to 90% in a few years so it’s expected the States will move forward in expanding Medicaid. Lew pointed out that college kids can stay on their parents plan, seniors no longer pay $600 because of the hole in Medicare, and parents with kids with preexisting conditions no longer worry about coverage or lifetime limits.

Lew also said Congress needs to act on the President’s proposals to create jobs (law enforcement, teachers, veterans, and infrastructure) and help people that are under water with mortgages; the Republican budget plan is to give $5 trillion in tax cuts to millionaires and the only way to pay for it is to cut benefits to middle class families through mortgage, health care and charitable donation exclusions. Tomorrow I’ll talk about Republican Congressman Paul Ryan’s response to this.  

Obama Care Provisions

Key provisions of the Patient Protection and Affordable Care Act (PPACA) enacted March 2010 by President Obama were designed to eliminate "the worst practices of the insurance companies", preserve private insurance and health care providers and provide more subsidies to enable the poor to buy insurance. In the first year: Insurance companies were barred from dropping people’s coverage when they got sick, ending the practice of rescission; lifetime coverage limits and restricted annual limits were eliminated; young adults can stay on their parents' health plans until age 26 (many were previously dropped when they turned 19 or finished college); uninsured adults with pre-existing conditions are now allowed to obtain health coverage through a new program for high risk pools (expires in 2014 when new insurance exchanges begin operating); Insurance companies can’t deny group or new individual coverage to children under age 19 due to a pre-existing condition; a temporary reinsurance program to help companies maintain health coverage for early retirees between the ages of 55 and 64 (expires in 2014) was created; it provides a $250 rebate to Medicare drug plan beneficiaries who fell into the Medicare Part D coverage gap (old law required the person to pay 100% of their annual medicine costs when $2,700 was spent and didn’t start again until after $6,154 was spent); the coverage gap eventually closes completely; provided a tax credit for some small businesses providing coverage for workers and a 10% tax on indoor tanning services that use ultraviolet lamps. During 2011 Medicare provided a 10% bonus payment to primary care physicians and general surgeons; covered the full cost of annual wellness visits and personalized prevention plan services for beneficiaries. New health plans were required to cover preventive services with little or no direct cost to patients. A new Medicaid program for the poor went into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care. Payments to insurers offering Medicare Advantage services are frozen at 2010 levels and are to be gradually reduced to bring them more in line with traditional Medicare. Employers were required to disclose the value of health benefits on employees' W-2 tax forms. An annual fee was imposed on pharmaceutical companies according to market share; the fee did not apply to companies with sales of $5 million or less. Effective 2012 physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care. A Medicare incentive program is established for acute care hospitals to improve quality outcomes. The Centers for Medicare and Medicaid Services, which oversees the government programs, begins tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions. (Amendments made by Section 9006 of the Act in April 2011 repealed a new tax reporting change to prevent tax evasion by corporations and individuals because the provision was burdensome to small businesses; it was expected to raise $17 billion over 10 years.)

Effective 2013 a national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care. The threshold for claiming medical expenses on itemized tax returns is raised to 10% from 7.5% of income; the elderly wait until 2017 for the change. The Federal Insurance Contributions Act tax (FICA) is raised to 2.35% from 1.45% for individuals earning more than $200,000 and married couples with incomes over $250,000 and is imposed on some investment income. A 2.9% excise tax is imposed on the sale of medical devices; generally doesn’t include purchases at the retail level.

Effective 2014 State health insurance exchanges for small businesses and individuals open up. Individuals with income from 133% of the federal poverty level (FPL) to 400% of the FDL will be able to purchase insurance on the exchange with a premium cap for maximum "out-of-pocket", qualify for Medicaid, get tax credits (Section 1401 of PPACA explains the subsidy will be provided as an advance-able, refundable tax credit that provides a government benefit to people even with no tax liability, example: Child Tax Credit). The Congressional Budget Office shows the maximum share of income that enrollees would pay for the "silver" healthcare plan would vary depending on their income relative to the FPL (a Subsidy Calculator gives a specific amount). People will either be on a government or private plan or pay a tax if they don't have health insurance; health plans will no longer be able to exclude people from coverage due to pre-existing conditions and employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange (30 employees aren't counted for the fine). Health insurance companies begin paying a fee based on their market share.

Effective 2015 Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services. Effective 2018 an excise tax on high cost employer-provided plans is imposed (first $27,500 of a family plan and $10,200 for an individual coverage is exempt); higher levels are set for plans covering retirees and people in high risk professions. (Unlike today, age and FPL enable those required to buy insurance to get a reduced rate.) Tomorrow I’ll talk about the Supreme Court’s June 28, 2012 decision and the talk that followed. By the way, 2 cable stations erroneously reported that the Court struck down the law.   

US Health Care History

The US has been trying to get health care of some type since 1854 when President Franklin Pierce vetoed a bill saying he believed social welfare was the responsibility of the states. Although European countries were passing social welfare acts and forming the basis for compulsory government-run or voluntary subsidized health care programs (United Kingdom passed the National Insurance Act of 1911), the US held to federal non-participation in social welfare (1912 Teddy Roosevelt, 1935 Franklin D. Roosevelt and in 1949 Harry Truman all tried and failed in getting universal health care). In the Civil Rights era of the 1960s and early 1970s, the predominant public opinion was toward the problem of the uninsured and supported universal coverage. Supporters of health care reform were able to avoid the worst fears of "socialized medicine" (considered a dirty word for its association with communism) and President Lyndon Johnson got Medicare and Medicaid passed on July 30, 1965. In 1968 a National Opinion Research Center poll reported that 87% of Americans believed that health care was a right of all American citizens. In 1972 two economists evaluated all the proposals in Congress and said "Universal coverage of the resident population … is justified … access to medical care is a necessity, not a luxury, and that universal protection is required. Universality cannot be achieved by voluntarism, even when supported by incentives. Publicly imposed means tests are destructive … and … almost always lead to a double standard and a 'two-class' quality of care. One of the objectives of a national system must be to end such discrimination." On February 6, 1974 President Richard Nixon introduced the Comprehensive Health Insurance Act; it would have mandated employers to purchase health insurance for their employees and provided a federal health plan similar to Medicaid that any American could join by paying on a sliding scale based on income. The New York Daily News wrote that Ted Kennedy rejected the Nixon plan because it wasn't everything he wanted (the Kennedy-Mills bill of 1974 was dropped because of Mill’s sex scandal) and he later realized it was a missed opportunity to make major progress toward his goal. By the late 1970s, with concern over rapidly rising health care costs, the idea of universal coverage had fallen flat and President Jimmy Carter’s plan failed. In 1985 President Ronald Reagan signed the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) which amended the Employee Retirement Income Security Act of 1974 to give some employees the ability to continue health insurance coverage after leaving employment. In 1994 President Bill Clinton tried to compromise on the Nixon-Kennedy differences but his plan failed. However in 1997 Clinton did get the State Children's Health Insurance Program passed to provide health insurance to children in families at or below 200% of the federal poverty line. Due to intense opposition from groups including the American Medical Association and pharmaceutical industry President George W. Bush was unable to pass the Patients’ Bill of Rights (would’ve provide emergency care to anyone regardless of health insurance status as well as the right of a patient to hold their health plan accountable for any and all harm); it failed Congress in 2002. Bush did sign the Medicare Prescription Drug, Improvement, and Modernization Act which included a prescription drug plan for the elderly and disabled Americans. In 2004 Bush proposed expanding health care coverage. In January 2007 the House introduced HR 676 - The US National Health Care Act and the Senate introduced the Healthy Americans Act (S. 334) and both failed. During the 2008 campaign John McCain and Barack Obama both offered health care proposals; the McCain plan was described as to make insurance more affordable while the Obama plan was for more people to have health insurance. A poll released in early November, 2008 found that voters supporting Obama listed health care as their second priority; voters supporting McCain listed it fourth, tied with the war in Iraq; affordability was the primary health care priority among the voters. In December 2008 the Institute for America's Future together with the chairman of the Ways and Means Health Subcommittee launched a proposal from the co-director of the U.C. Berkeley School of Law Center on Health that said the government should offer a public health insurance plan to compete on a level playing field with private insurance plans; it concluded that the public plans had success at managing cost control (Medicare spending rose 4.6% compared to 7.3% for private health insurance on a like-for-like basis in the 10 years from 1997–2006); public insurance has better payment and quality-improvement methods based on its large databases, new payment approaches and care-coordination strategies; and a standard would be set against which private plans must compete which would help unite the public around the principle of broadly shared risk while building greater confidence in government over the long term. This proposal was said to be the basis of the Obama plan.

In a June 2009 NBC News/Wall Street Journal survey 76% said it was either "extremely" or "quite" important to "give people a choice of…a public…and a private plan for their health insurance.” A NY Times economist editorial said "The fundamental fact is that we can afford universal health insurance--even those high estimates were less than the $1.8 trillion cost of the Bush tax cuts." The Supreme Court on June 28, 2012 ruled that people who do not purchase health insurance can be taxed at a different rate; their 5 to 4 decision affects the 2014 portion of the bill (to be addressed tomorrow). Since 2009 the Tea Party has fought against health care reform and Republicans vow to continue to try and stop the 150+ year fight that can be paid for by discontinuing the tax cuts for the rich.  

Taking a Break

I have decided to take a 30 day break to clear my head of the news and people who care about their individual issues instead of the country as a whole. From people who don’t understand that they have a right to a religion because our Constitution doesn’t allow the government to have one. Without a religion our government:

• Does not stop a woman’s right to an abortion or birth control (an opportunity brought on by medical progress since the beginning of religions). 
• Has decided (1879 Supreme Court) that polygamy is against the law (On June 1, 2012 I heard Utah prosecutors are not bringing criminal charges against the polygamist family made famous on the reality show Sister Wives.). 
• Does not prosecute for adultery, eating of any food, having a religious symbol, working on the Sabbath, and more. 
• Does prosecute those that hurt children via their failure to provide medical assistance, beatings, trafficking, and more. 
• Believes in a death penalty (too many states have twisted their laws to believe otherwise). 
• Has decided we are all to be treated equally. Blacks, Hispanics, Gays, Catholics, Baptists, Muslim, etc. (On June 1 a Boston federal appeals court found the 1996 Defense of Marriage Act to be unconstitutional; it’s finally going to the Supreme Court.).

There is so much more I am irritated with but I don’t want to go into those not wanting health or house insurance and wanting the government to foot the bill; or the $1.8 trillion in tax cuts given to the rich when there’s 15% of Americans that are poor and starving, or our freedom of speech that allows people to lie, foolishly demonstrate (not slaughtered like Syrians) or to teach children to hate and persecute while their so-called Christians churches get government tax exemptions (perhaps the tax code should be changed to disallow them). And, I truly don’t understand why so many Americans don’t comprehend why the Wall Street protesters are acting on their behalf. 

The Republican Beast

On May 24, 2012 Republican Joe Scarborough was on the View and said he doesn’t like Romney (he liked Huntsman) - he could find an issue of Romney’s that he does like but doesn’t know where he’ll stand tomorrow; he also said the only thing the Republican Party is trying to do is get back in power and that we need someone who talks about the future not the past – I think he has a point. 

Let’s look at our leaders starting with the Reagan Republican Presidency (81-89). From 1981-87 the House had a Democratic majority and the Senate was controlled by the Republicans. From 1987-89 both the House and Senate were controlled by the Democrats (last 2 years of Reagan). During the 4 years of George HW Bush’s term (89-93) both the House and Senate were controlled by the Democrats. From 1993-95 both the House and Senate were controlled by the Democrats (first 2 years of Bill Clinton’s 93-01 Democratic Presidency). From 1995-2001 both the House and Senate were controlled by the Republicans; we had a government shutdown (1995-1996) and they tied his hands on many issues. During George W. Bush’s Republican Presidency (01-09) we had a Democratic Senate and Republican House for his first 2 years (01-03) and then both the House and Senate were controlled by the Republicans from 2003-07; the Middle East wars were raging and the economy began to fall. From 2007–11 both the House and Senate were controlled by the Democrats (last 2 years of Bush and the first 2 years of Obama’s Democratic Presidency). From 2011–13 we have a Republican House and Democratic Senate; we had a budget fiasco last year and we’re probably due for the same thing this year.  

A Republican has been in office for 20 years of the last 32; they always tout the politics of Reagan but none of it could’ve occurred without the cooperation of the Democrats. During the 2 Democratic presidencies because of the Republican’s strength in Congress we had a government shutdown and a drop in our credit rating because of a near miss in meeting the budget deadline.  

Over and over again we’ve heard about the money the Republicans are putting into the campaign and we heard it again to May 19 so I believe Scarborough is right in saying they only want to get back into power. Trump can say he backs Romney now but he can’t say when there were more in the race that he always backed him; in fact he considered running himself. On May 25 Trump was asked if he would consider holding the Vice Presidency or any post if Romney offered and he said he would. Whoopi pointed out that if he were in any office he’d have to tone down (talked about his Twitter feud with Cher); Barbara pointed out (and he agreed) that he doesn’t turn the other cheek and he says get even – fire them; Joy pointed out that those in office shouldn’t make personal attacks on people. Romney wasn’t good enough when he first ran for the presidency and he’s not good enough now.

On May 13 it was said that 1.8 students would graduate this year and 94% will have outstanding loans and 3 in 10 would be moving home to live with their parents. A week prior to this Romney told students to shop around for cheaper (tuition) rates and on this date he’s agreeing that loan rates shouldn’t be increased; according to a recent study 93% of parents are providing their students with some form assistance (loans, car payments or rent). On May 24 Romney said American students are getting a third-world education and proposed a voucher style program; he says it’s the civil rights issue of our era. I want to know who will monitor his system to ensure a better education and no fraud is created. I also want to know why the Republicans are holding the student interest rates as hostage for extending the Bush-era tax cuts to the rich.

On May 22 a Washington Post poll showed 16% of Americans said their finances have improved while 30% said they’ve gotten worse since Obama; Newark, New Jersey Mayor Corey Booker didn’t help – on Meet the Press he said he didn’t like the continued campaign against Romney’s work at Bain Capital and now he’s angry because the GOP is using his words against Obama. I agree with the President that working in private industry is not the same as working in federal politics (Romney has never held a federal position).

If something happened to our world I would need hunters/butchers, farmers, canners, textile workers and others associated with clothes manufacturing, cobblers, general practitioner doctors and surgeons, antibiotics and other drugs, carpenters, electricians, plumbers, teachers, barbers, and more. I won’t need Wall Street, hell I’d rather have a toilet paper maker before a stock trader, speculator, or financial advisor and I won’t need greedy oil tycoons. In early May a Republican said risk takers and investors are worth more and are needed. I don’t think the rich are worth more than the everyday people who put in a real day’s work (at a low pay and without health insurance) to make them rich. I again say that if you really want change Obama needs to be re-elected. I also think the Republicans need to be booted out of Congress to prove the point that we are fed up with things the way they’ve been. If this would happen Obama would have a chance to implement the changes necessary to give people jobs, health care and education. I believe that all of these, not just an education as Romney has said, are human rights issues along with others that the Republicans don’t support.     

US Import/Export

On December 14, 2011 CNNMoney reported that the Commerce Ministry of China announced increased duties on US made sedans and SUVs, raising the cost of those vehicles to Chinese buyers by between 2% and 21.5%; the new tariffs will last for 2 years. CNN said the action could imperil billions in sales by Detroit automakers. Experts in the field said they don't expect the import duties and lost sales to be a significant blow to the US automakers since most of their sales there won't be affected; it's likely a move by the Chinese to try to block the US from filing any additional sanctions against its own exports here. "They're basically saying if the US tries to put tariffs on imported goods from China, they'll retaliate," said Rebecca Lindland, director of research at IHS Automotive. The US Trade Representative's office (the advocate in trade disputes) said it was "very disappointed in this action by China today" and would consult with Congress and US automakers about how best to respond.

On May 15 we heard that in the past 10 years (China entered the World Trade Organization in 2001) American exports to China increased 542%. I found this came from The Hill’s On the Money Report of March 27 that said - total US exports to China rose 542 percent to $103.9 billion in 2011 from $16.2 billion in 2000 making the communist nation the third-largest US export market). The On the Money report also said exports rose $102 billion to Canada, $86 billion to Mexico, $28 billion to Brazil and despite the substantial increase in exports, the US share of imports into China has fallen to 7% from 10% in 2000 making the United States only the fifth-largest source of Chinese imports last year. The report suggested that as part of President Obama’s plan to double exports by 2014 he should try to reclaim the 10 percent share of China’s imports. The US-China Business Council (USCBC – a group of about 220 American companies doing business with China; they’re charged with analyzing the business climate for companies who are doing or wish to do business in China) suggested that policymakers can bolster US trade to China by expanding capacity and resources for the foreign commercial service which helps small and medium exporters find more export opportunities. The USCBC is urging reauthorization of the Export-Import Bank (Congress so far has rejected proposals to provide funding for the bank) and call on the funding of the US Trade Representative's office so it can continue helping exporters understand and remove market access barriers. Okay, I’ll go with funding the US Trade Representative office but not the bank; let businesses get their money from the TV show Shark Tank investors or someone other than the government.

On May 25, 2012 Donald Trump was on the View. He said he likes what Romney is saying about OPEC and China ripping us off; Columbia $4 billion, China $350 billion and we have to do something about it. First, I think these guys should read my Oil 101 blog of May 23 to find out we get the majority of our oil from Canada, not OPEC. Now, let’s look at this rip off. In 2011 the US exported $129 billion in goods and services to China while it imported $411 billion from China; leaving a $282 billion deficit for the US. The largest imports from China are: electrical machinery ($98.7 billion), machinery ($94.9 billion), toys and sports equipment ($22.6 billion), furniture and bedding ($20.5 billion) and footwear ($16.7 billion). We also imported $4 billion in agricultural products such as fruit, vegetables, juices, snack food, and spices. (Our top exports to China are: transportation equipment/machinery ($12.2 billion), agricultural products such as soybeans, cotton, hides and skins, and coarse grains ($18.9 billion), electrical machinery ($10.1 billion), vehicles ($6.8 billion) and aircraft ($6.4). The latest data available for investments were for 2010. This data showed US investments were led by the manufacturing and banking sectors to the tune of $60.5 billion (up 21.4% over 2009) and China’s investment in US stock was $3.2 billion (up 171.6% from 2009) and led by the wholesale trade sector. What this means is that the US companies gave (they didn’t take) more business to China than to the US people.

The trade figures for January – March 2012 show that the US exported $27 billion to China while it imported $94 billion – a $67 billion deficit. We heard on February 22 that Neutex brought its LED light bulb business back from China to Houston, Texas and GalaxE (an IT firm that connects patient’s medical records) is going to Detroit, Michigan from India. But as long as businesses such as Apple (May 3 – Indifference our Downfall blog), Nike, WalMart and others choose to invest in the Chinese worker over the American worker, nothing will change. Romney and Trump can tout a change but since they support big business I doubt that they’ll do anything that will redirect work back to the US. And don’t forget about the infrastructure projects in Alaska, California and New York that went to Chinese workers to the tune of $7.8 billion (October 8 blog – Going Without).   

On May 25 we were told that the US and world economies are slowing down; in the US, businesses are cutting back on machines and computers; China reported a drop for the 11^th month in a row and Europe’s economy has hit the biggest low in 3 years. While American businesses slow down their spending on US products and workers the US House is planning a summer session to extend the Bush-era tax cuts to the rich. Yes, on March 30 Exxon Mobile lost its title to a Chinese company as the world’s largest oil trading company but it’s still a multi-billion dollar business. We’ve been doing things the rich man’s way; they got us into this mess – please stop listening.