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Tuesday, September 10, 2013

Health Care Reform Articles - September 10, 2013


Money, greed, power are behind the gridlock

Posted Sept. 08, 2013, at 1:21 p.m.
Our democracy is grinding to a halt from the corrupting influence of money, not honest differences in ideology or political views. Big money is behind all of our major stumbling blocks.
Big business is not creating jobs because it can make huge profits without them. Global robber barons don’t need an educated, employed, middle-class America to make their billions. They keep transactions too complicated to understand, regulations and taxes too weak to restrict them and their businesses too big to fail.
America is always at war somewhere, not just because of national defense or ideology but excessive profits of a military-industrial complex that President Dwight Eisenhower warned us against.
Our health care system was developed to provide corporate profits, not health care. It is far more expensive than that of other developed countries because of lobbyists from insurance and pharmaceutical companies. They don’t want us to know that the single-payer, Medicare system is best by far.
Social Security is not insolvent, doesn’t increase the deficit and is weakened only because the fund was raided to pay for other programs. Privatization would only boost industry profits at our expense.
Tax laws are grossly unfair, too complicated and favor the rich, but they won’t be reformed anytime soon because they are written by corporate accountants, lawyers and lobbyists who benefit from the status quo.
We can’t solve our education problems because real solutions are not quick political fixes but complex, expensive and long-range. Billionaires no longer need educated American consumers, voters and workers to make their money. They make more by keeping the public ignorant and poor.
We can’t require business practices that protect our environment and natural resources because the rules are written by lobbyists from coal, gas and big oil. They protect their obscene, record-breaking profits at our expense.
The real opponents of gun control are makers and distributors of profitable guns and ammo. Wayne LaPierre does not represent the National Rifle Association majority, which favors background checks. He is a straw man sent to divert attention from the industry by stirring up ideological controversy.
The news media is not the guardian of truth, which is often too complicated, time-consuming, expensive and boring. They are in business to make money, through paid advertising and sensationalism. “Balanced” reporting of talking heads is not fact-finding journalism that produces an informed public.
Most corruption has been in Washington, where the money is, with state and local governments inheriting the loss of federal dollars. Now power brokers realize the key to influencing the national agenda is control at state and local levels — not only of who gets elected but who gets to vote.
Phony political crises hyped by news media are a farce to distract us from important, difficult issues not being addressed, such as jobs. A good example is Internal Revenue Services’ scrutiny of tax-exempt applications. No political group should have tax-exempt status to take huge, secret contributions, while we pay their operating expenses.
These controversies are just to keep us from understanding how bad things really are — while politicians enjoy attention, fame and fortune. The revolving door between big business and government allows the same people to remain in power, whether influencing from the outside or within. Politicians accept money to gain and keep their jobs. Even our votes aren’t sacrosanct anymore, as our will is now routinely ignored.
This cozy business-media-political partnership will continue only as long as we remain ignorant, complacent and compliant.
Here is what we can do to fix things.
• Recognize the problem as critical and get involved.
• Call out politicians and the media for false, baseless hype.
• Remove politicians driven by big money and party loyalty.
• Reject products and services from partisan advertisers.
• Support and share messages and petitions for real reform.
• Send letters to editors and congressional representatives.
• Become active in local, state and national reform groups.
• Reject voting restrictions and gerrymandered districts.
• Support reversal of the Supreme Court’s Citizens United ruling.
• Demand the return of 51-vote Senate majorities.
• Support legislation to control big banks.
• Support fair incentives for business investment in America.
We have a crucial choice. We can let our country deteriorate into a plutocracy that benefits only people at the top. Or we can wrench the power back and restore our democracy of, by and for the people. We must get this country growing again for all Americans, but we’ve got to do it together, right now.
David Estey is a fine-arts painter in Belfast and a retired IRS regional manager of public affairs for five middle Atlantic states and Washington, D.C.


Graphic Ads Motivate Smokers to Quit

For almost two decades, Lisha Hancock smoked between one and two packs of cigarettes a day.
Her husband often urged her to quit, but neither his pleading nor the fact that several of her relatives died from smoking-related complications could persuade Ms. Hancock to stop.
The smoke she inhaled constantly bothered her throat and clogged her sinuses. Rather than give up smoking, though, Ms. Hancock started taking an antihistamine so she could ease the irritation in her throat and continue lighting up.
Then she saw a graphic television commercial featuring a former smoker, Terri Hall, who developed head and neck cancer. The widely seen advertisement shows Ms. Hall inserting a set of false teeth and placing a small speaker inside a hole in her neck.
“It scared me because I had always had problems with my throat,” said Ms. Hancock, 38, who lives in Kentucky. “When I saw that, it made me realize that there are other types of cancer besides lung cancer, and that really hit home for me.”
The ad prompted her to give up smoking about eight months ago, using a combination of an exercise and healthful eating regimen along with nicotine lozenges, and she has not had a cigarette since. But Ms. Hancock may be just one of thousands of Americans who quit smoking after seeing the commercial featuring Ms. Hall, which was part of a series of antismoking ads put out by the federal government last year. The campaign, called Tips From Former Smokers, was notable both for its raw images and because it marked the first time that the government directly attacked the tobacco industry in paid, nationwide advertisements.
According to a new study published on Monday in The Lancet, the ads may have prompted more than 100,000 Americans to give up smoking for good.
The study, led by a team at the Centers for Disease Control and Prevention, surveyed 5,300 Americans before and after the campaign, including 3,000 smokers. The paid ads ran for three months beginning in March, just after the New Year resolution season, when the percentage of smokers trying to quit is typically on the decline.
The researchers found that over all, four of five of smokers had seen the commercials, and the percentage who reported trying to quit rose by 12 percent. Of those who tried to quit, about 13 percent remained abstinent after the campaign had ended.
Using census data, the researchers estimated that as many as 1.6 million smokers nationwide attempted to quit as a result of the ad campaign. Most smokers require several attempts before they give up cigarettes for good, so only a fraction of those who were motivated by the campaign would have succeeded. The ads were expected to spur about 50,000 smokers to quit permanently, but the Lancet study estimated that twice that number were successful.
“We had very ambitious goals for this program,” said Dr. Thomas Frieden, the director of the C.D.C., “and it succeeded beyond our highest hopes.”

From ‘Inequality for All,’ a challenge for America

By Tuesday, September 10, 8:06 AM

“Chilling.”
That’s how one reviewer describes the experience of watching Harvey Weinstein’s latest film. Only the movie in question isn’t “Erased,” Weinstein’s pulse-pounding thriller about an ex-CIA agent on the run. Nor is it “Only God Forgives,” in which Ryan Gosling finds himself caught up in a gritty underground world of Thai drug smuggling, prostitution, rape, and murder.
The movie is, in fact, a documentary, but one more disturbing than international criminal conspiracies and more devastating than any “Sharknado.” It’s about income inequality. As Clinton Labor Secretary Robert Reich intones in the film, “Of all developed nations, the United States has the most unequal distribution of income, and we’re surging towards even greater inequality.”
“Inequality for All,” directed by Jacob Kornbluth and set to be released nationwide on Sept. 27, comes at a critical moment for America. Sept. 15 marks the five-year anniversary of the collapse of Lehman Brothers — fueled by a toxic combination of deregulation, subprime lending and credit-default swaps — that precipitated the 2008 global economic crisis and laid bare the rot at the heart of our economic system. It was largely this orgy of greed that led the first Occupy Wall Street protesters to Zuccotti Park on Sept. 17, two years ago next week.
In the half-decade since Wall Street’s self-induced crash, the country has hovered between outrage (that the perpetrators walked off scot-free and bonus-laden) and apathy (that anything will ever break the iron bond between Congress and the financial industry).
Until now, hopefully. Following the diminutive Reich on his “statistics-driven and impassioned” crusade, “Inequality for All” throws into sharp relief the numbers and stories we hear. Combining footage from Reich’s electrifying Berkeley lectures with interviews, news clips and rich graphics, the film weaves a compelling narrative about how and why, since the late 1970s, income inequality has risen to crisis levels.
The facts are breathtaking. In 1978, according to Reich, a “typical male worker” made $48,302, while the typical top 1 percenter earned $393,682, more than eight times as much. In 2010, even as overall gross domestic product and productivity increased, the average male worker’s wage fell to $33,751. Meanwhile, the average top 1 percent earner was making more than $1.1 million — 32 times the average earner.
Reich cleverly illustrates how the graph of American inequality over the past century looks like a suspension bridge — peaking in the 1920s, leveling out because of strong, progressive policymaking in the 1950s and 1960s, and spiking again from the Reagan years through the present. We see the consequences in middle-class families that have fallen off that bridge and are struggling to stay afloat.
The film’s most refreshing figure may be Nick Hanauer, a millionaire pillow company CEO who made a fortune as an early investor in Amazon.com. Hanauer acknowledges that he earns 1,000 times the average American but that he will never generate a proportionate amount of economic activity — because he will never need 1,000 Audis or 1,000 pairs of jeans. As he puts it, “Even the richest people only sleep on one or two pillows.”
That’s why this mind-boggling income gap isn’t just bad for families — it’s terrible for the whole economy. Research shows that the increasing chasm between the top 1 percent and everybody else has slowed our nation’s economic growth.
http://www.washingtonpost.com/opinions/katrina-vanden-heuvel-from-inequality-for-all-a-challenge-to-america/2013/09/10/45d69404-1957-11e3-8685-5021e0c41964_print.html


latimes.com

Conservative group pushes its plan to cripple healthcare overhaul

An 'Exempt America from Obamacare' rally, urging Republican lawmakers to refuse to vote for a spending law unless it eliminates money for the healthcare law, is set for Tuesday.

By Michael A. Memoli
8:38 PM PDT, September 9, 2013
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PITTSBURGH — In a hotel conference room overlooking this city's downtown, the leaders of one of the nation's largest conservative advocacy groups outlined a plan to cripple President Obama's healthcare law.
With funding for government operations set to run out at the end of this month, Heritage Action, part of a coalition of conservative lawmakers and outside groups, wants Republicans to refuse to vote for a law that would authorize spending unless it also eliminates money for the healthcare law, a move that would hobble the Obama administration's efforts to launch Web-based insurance marketplaces Oct. 1.
"This is the time to fight," said Jim DeMint, a former South Carolina senator who is president of the Heritage Foundation, a conservative think tank allied with Heritage Action. "If there has ever been a political issue that's worth standing up and fighting and taking a risk for, this is the time to do it."
The Heritage event, which drew about 700 conservative activists, was aimed not at Obama or Democrats but at the area's six-term Republican Rep. Tim Murphy, who was not among the 80 House Republicans to sign a letter urging Speaker John A. Boehner (R-Ohio) to embrace the strategy. Boehner could bring the issue to the House floor for a vote as soon as Thursday.
Murphy, a psychologist who has focused on health policy, would seem an unlikely target. On that same muggy August night, he was about 30 miles away in the council chambers of the little city of Washington, Pa., warning government officials and business leaders about the 2010 healthcare law.
In a slide-show presentation, he noted that elements of the law were being delayed by the administration and said rates would shoot up in some states. "The truth is, the government isn't ready," he said.
Murphy has voted with his party many times this year to undercut or repeal the Affordable Care Act and has backed legislation to strip its funding. As chairman of the energy and commerce subcommittee on investigations and oversight, he's called numerous hearings on the law, including one in July on the administration's decision to delay the mandate that certain employers provide insurance for their workers or pay a fee.
But to some in the conservative movement, that's not enough.
"We are in a war against people who fundamentally have a different view of government.... There's no compromise in that," Mike Needham, chief executive of Heritage Action, said at the town hall, one of nine it held in the districts of Republican lawmakers who have not backed their effort.
http://www.latimes.com/nation/la-na-healthlaw-battle-20130910,0,96772,print.story


What your health insurance might look like under Obamacare

Posted Sept. 09, 2013, at 5:56 a.m.
What are your options under the Affordable Care Act? Here are some examples — with the help of some (slightly re-imagined) characters from “Grey’s Anatomy.”
Izzie, 24, single, no kids, doesn’t smoke. Lives with mom and dad in Bangor while she saves up money for medical school. She makes $16,000 a year working part-time for a modeling agency that doesn’t offer insurance.
The options:
— Because she’s under 26, Izzie can stay on her parents’ insurance.
— Because she’s under 30, Izzie can buy a low-cost, high-deductible catastrophic insurance plan. If purchased through the marketplace, it will cost her $184 a month with Maine Community Health Options or $209 a month with Anthem Blue Cross and Blue Shield. If Izzie takes up smoking, Anthem’s price will jump to $271 a month. (Should she move out of Penobscot County, those prices could change.)
— Because Izzie earns between 100 percent and 400 percent of the federal poverty level, she can get a subsidy from the federal government to help pay for her insurance. (However, it can’t be used for a catastrophic plan. If she wants a subsidy, she’ll have to buy a more comprehensive bronze, silver or gold-level plan from the marketplace.) The Kaiser Family Foundation’s online calculator puts her subsidy at $2,479 a year, or about 82 percent of her annual premium.
And, because Izzie earns less than 250 percent of the federal poverty level, she can also get a subsidy to lower her out-of-pocket expenses.
— She can go without insurance and pay the penalty. For a single woman, that will be $95 or 1 percent of her income, whichever is greater, for 2014. The penalty increases in future years.
Meredith, 39, and Derek, 41, married with two young children. The McDreamys live in Lewiston, work as doctors and make $200,000 a year between them. They get affordable family health insurance through their employer, one of the largest hospitals in the state.
Options:
— Meredith, Derek and their children can stay on the employer health plan. No change needed.
— They can ditch their employer coverage and buy insurance for themselves and their children through the exchange/marketplace. However, because their employer offers affordable insurance and because the family’s income is well above the poverty level, they won’t receive a subsidy.
— They can ditch their employer coverage and buy from an insurance agent. However, as with the exchange/marketplace, they’ll be responsible for the whole cost.
— They can go without insurance and pay the penalty. For 2014, that penalty will be 1 percent of family income or $95 per adult and $47.50 per child (up to $285 per family). The penalty increases in future years.
Preston, 70, single, no children. Lives in Portland. Currently on Medicare.

Consumers With Serious Medical Problems Need To Carefully Assess Total Plan Costs

SEP 10, 2013
One of the health care overhaul's most far-reaching provisions prohibits health plans from refusing to cover people who are sick or charging them higher premiums. Still, for people with serious medical conditions, the online health insurance marketplaces present new wrinkles that could have significant financial impact.
Obviously, premium costs will be an important consideration for consumers. But just as important will be a realistic assessment of what kinds of out-of-pocket costs they could expect with different types of policies and what subsidies they will be eligible for.
"Everybody should be factoring in cost sharing along with the premium to try to assess what their total financial exposure is," says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundadtion. (KHN is an editorially independent program of the foundation.)
The law requires new individual and small group plans sold on the online marketplaces, also called exchanges, and on the private market to cover a comprehensive set of 10 "essential health benefits," including prescription drugs, hospitalization and doctor visits. The benefits covered will be similar in all plans, but the proportion of the costs that a consumer pays will vary.
There will be four different levels of plan coverage, each identified by a precious metal: Platinum plans will pay 90 percent of covered expenses, on average; gold plans will pay 80 percent, silver plans 70 percent and bronze plans 60 percent.
Tax credits to help cover the cost of the premiums for plans sold on the exchanges will be available to people with incomes up to 400 percent of the federal poverty level ($45,960 for an individual in 2013), and cost-sharing subsidies will reduce the out-of-pocket costs for people with incomes up to 250 percent of poverty ($28,725 for an individual in 2013). The maximum amount that consumers will owe out of pocket for in-network medical claims will generally be capped at roughly $6,400 for individuals and $12,700 for families in 2014. (Those figures do not include money spent on premiums.)
How all those elements work together can have cost and coverage implications for people with high medical expenses.


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