One of the biggest problems I've had with the debate over the Affordable Care Act from day one has been semantics. First off, use of the term "Affordable" has applied to a select few when it comes to the purchase of health insurance. And those "young and healthy" enrollees had to pay more for their policies to offset the influx of "old and sick" that insurers were required to cover. In addition, the cost of care has continued to increase at a pace faster than inflation (although, not quite as fast as before the ACA). The medical device tax has raised the prices on equipment both consumers and providers have had to pay--and has sent that industry overseas for cheaper labor costs.
Plus, President Obama has repeatedly said that Americans are "guaranteed to get the care they need". That is also not true--particularly for the 7-8 Million people who joined Medicaid programs in the states that were suckered into taking the short-term increase in Federal funding. You see, a new study finds that fewer than half of doctors in specialty and advanced care practices actually see Medicaid patients. And the minority of doctors that do accept Medicaid have substantially longer wait times for appointments and procedures.
Physicians who decline Medicaid do so for the very simple reason that the government program grossly underpays for the services provided. Plus (as you might expect from a government program) the process of filing a claim for payment is onerous and Uncle Sam slow pays--meaning practices have to carry costs much longer than they should. This underpayment is another of the shady accounting tricks contained in the Affordable Care Act to make it seem cheaper than the Trillion dollar price tag attributed to it.
A cardiologist that performs heart surgery or a dermatologist that treats a skin condition can expect Medicaid reimbursement of just a fraction of the actual value of the service. Supporters of the practice claim it "helps drive down the cost of health care". But you don't see Uncle Sam "driving down the cost of military defense" by telling Boeing that it's only going to pay 2-million dollars for that 10-million dollar fighter jet--because the Pentagon knows that Boeing would not be building any more fighter jets.
So as we "celebrate" so many more people having health care "coverage", keep in mind that about half of them will find it very difficult to actually use it to get health "care".
Friday, May 9, 2014
Thursday, May 8, 2014
The End of Work
Yesterday, I talked about the bleak job and economic future facing those graduating from American colleges this year. A few hours later, Jim Sciutto--a reporter for CNN--retweeted on Twitter a graphic that shows compared to what young people in Europe are facing, the US is still the land of milk and honey:
Unemployment for those under the age of 25 is 23% in the European Union--with the rates reaching an astounding 54% in Spain and a whopping 57% in Greece. And this is not a recent development, "youth unemployment" has been above 20% across the EU for better than 5 years now.
Sciutto calls this a "real and under-covered" crisis. I'd disagree that it is under-covered. Fiscal conservatives who oppose the Socialist systems of many EU members have known about this for some time--and have pointed to the effects of high taxes on income and corporations along with a safety net that is more like a safety hammock. The reason the "mainstream media" doesn't report on European unemployment is that so many people over their are perfectly content not to work.
You don't see tens of thousands of young protesters taking to the streets of London, Madrid or Rome demanding the government get them jobs. There are no violent clashes with police, or people throwing Molotov Cocktails through the front windows of corporate headquarters or bank branches in a "Proletariat" show of force against the "Bourgeoisie". That is the kind of thing that garners "media attention". The only such incidents that did make the news were violent protests in France by immigrants who are being denied work and in Greece--where residents were upset that overly-generous government benefits were going to be cut.
The lack of concern by those who are unemployed--or underemployed--in the European Union comes from the fact that most are more than happy with the way things are. They may not work but they still have social insurance payments, free health care, free birth control, subsidized college education and rental assistance. As long as you have money to sit in the cafe all day--and at the pub or discotheque all night--why ruin a good thing? Former House Speaker Nancy Pelosi would probably applaud these deadbeats--saying how "great it is that these young people can ease their way into the real world and not have to worry about finding a job right away to pay for things."
If you notice, the one country bucking the trend in the EU is Germany. Their unemployment rate for those under 25 went down over the last five years to just 7.7%. That is due largely to the cultural heritage of young people moving into technical fields and apprenticeships--rather than attending liberal arts colleges--out of high school. It's amazing what happens when you teach someone the value of work early in life--and stop giving them every reason not to earn a living.
Unemployment for those under the age of 25 is 23% in the European Union--with the rates reaching an astounding 54% in Spain and a whopping 57% in Greece. And this is not a recent development, "youth unemployment" has been above 20% across the EU for better than 5 years now.
Sciutto calls this a "real and under-covered" crisis. I'd disagree that it is under-covered. Fiscal conservatives who oppose the Socialist systems of many EU members have known about this for some time--and have pointed to the effects of high taxes on income and corporations along with a safety net that is more like a safety hammock. The reason the "mainstream media" doesn't report on European unemployment is that so many people over their are perfectly content not to work.
You don't see tens of thousands of young protesters taking to the streets of London, Madrid or Rome demanding the government get them jobs. There are no violent clashes with police, or people throwing Molotov Cocktails through the front windows of corporate headquarters or bank branches in a "Proletariat" show of force against the "Bourgeoisie". That is the kind of thing that garners "media attention". The only such incidents that did make the news were violent protests in France by immigrants who are being denied work and in Greece--where residents were upset that overly-generous government benefits were going to be cut.
The lack of concern by those who are unemployed--or underemployed--in the European Union comes from the fact that most are more than happy with the way things are. They may not work but they still have social insurance payments, free health care, free birth control, subsidized college education and rental assistance. As long as you have money to sit in the cafe all day--and at the pub or discotheque all night--why ruin a good thing? Former House Speaker Nancy Pelosi would probably applaud these deadbeats--saying how "great it is that these young people can ease their way into the real world and not have to worry about finding a job right away to pay for things."
If you notice, the one country bucking the trend in the EU is Germany. Their unemployment rate for those under 25 went down over the last five years to just 7.7%. That is due largely to the cultural heritage of young people moving into technical fields and apprenticeships--rather than attending liberal arts colleges--out of high school. It's amazing what happens when you teach someone the value of work early in life--and stop giving them every reason not to earn a living.
Wednesday, May 7, 2014
As You Go Out Into the Real World..........
If I was delivering a college commencement speech this month, I would probably go easy on the "optimism for the future" stuff. A new report from the Economic Policy Institute finds job prospects for those just getting out of school continue to be pretty dismal. This for a generation that already finds itself dealing with an unemployment rate of 14.5% for those under the age of 25 (and of course that only counts those actively looking for full-time employment and not those who have resigned themselves to part-time work and moving back in with Mom and Dad).
Also this week, one of the leading hedge fund investors recommended staying away from home construction companies because those in their twenties and early thirties today are likely never to own a house. Mortgage lending has already fallen to its lowest level in 14-years, as renting (or the aforementioned living with Mom and Dad) becomes the only viable financial option for young adults without jobs and student loans on degrees in fields that have little demand.
A glimmer of hope appeared on the horizon this week as the Wisconsin Taxpayers Alliance released a report showing a potential workforce shortage in the state over the next 25-years--as Baby Boomers and Generation X'ers leave the workforce for retirement. That could mean more employment options, higher wages and some job security--but employers are already warning that those entering the workforce don't have the job skills (or interest in the available positions) to be hired. There are a lot of older workers on those paper machines, forklifts, welding kits and production lines--but it's a lot of MBA's and marketing degreeholders sitting around waiting for a job. That's not exactly a good match.
And to add injury to insult, the percentage of older, sicker people who signed up for health insurance under the Affordable Care Act was higher than that of the younger, healthier folks--so that will mean higher-than-anticipated premiums for those MANDATORY policies going forward.
If the commencement speaker is older than the graduates, I would probably recommend taking a more apologetic tone in your speech. Admit that we have screwed things up royally by borrowing away their futures--and then putting policies in place that will stick them with the bill. I probably wouldn't remind them of all of the "Hope and Change" they were promised six short years ago. And I would work on my Humphrey Bogart impersonation to wrap up with "We'll always have health insurance."
Also this week, one of the leading hedge fund investors recommended staying away from home construction companies because those in their twenties and early thirties today are likely never to own a house. Mortgage lending has already fallen to its lowest level in 14-years, as renting (or the aforementioned living with Mom and Dad) becomes the only viable financial option for young adults without jobs and student loans on degrees in fields that have little demand.
A glimmer of hope appeared on the horizon this week as the Wisconsin Taxpayers Alliance released a report showing a potential workforce shortage in the state over the next 25-years--as Baby Boomers and Generation X'ers leave the workforce for retirement. That could mean more employment options, higher wages and some job security--but employers are already warning that those entering the workforce don't have the job skills (or interest in the available positions) to be hired. There are a lot of older workers on those paper machines, forklifts, welding kits and production lines--but it's a lot of MBA's and marketing degreeholders sitting around waiting for a job. That's not exactly a good match.
And to add injury to insult, the percentage of older, sicker people who signed up for health insurance under the Affordable Care Act was higher than that of the younger, healthier folks--so that will mean higher-than-anticipated premiums for those MANDATORY policies going forward.
If the commencement speaker is older than the graduates, I would probably recommend taking a more apologetic tone in your speech. Admit that we have screwed things up royally by borrowing away their futures--and then putting policies in place that will stick them with the bill. I probably wouldn't remind them of all of the "Hope and Change" they were promised six short years ago. And I would work on my Humphrey Bogart impersonation to wrap up with "We'll always have health insurance."
Tuesday, May 6, 2014
The Latest Excuse
In the days before Brown vs Board of Education and school desegregation in the US, if someone said to you that white teachers wouldn't be able to teach black kids anything (or conversely, black children wouldn't be able to learn from white teachers) how would you have reacted? You likely would have told that person that they were ignorant, a bigot and a racist. You would have accused them of perpetuating stereotypes, insinuating white supremacy and trying to "keep minorities in their place". And you certainly would have been right to say that.
So why then are we so accepting of the very same argument for poor performance by minority students in Wisconsin? Superintendent Tony Evers has formed a task force to address the performance gap--and it's chairman stated on Upfront With Mike Gousha that one of the issues is that white teachers "don't relate" to black students. In our own interview with Oshkosh School Superintendent Stan Mack last week, he called having a teachers with a "99% middle class white background is a 'problem'".
This of course begs the question of what difference race makes in knowing that 2+2=4. And I'm pretty sure that George Washington was the first US President for blacks as he was for whites. Of course, kids aren't asked straight-forward questions like that or their tests anymore. Instead the questions are all word problems (Sally has two seasons of Game of Thrones downloaded on her IPad and two seasons of the Walking Dead. How many seasons of shows can she watch since kids aren't expected to do homework anymore?) Or they ask kids how they "feel" about things (George Washington owned slaves, how do you think that makes African-Americans feel when they see his picture on the dollar bill?)
The "racial teaching disparity" is just the latest excuse those in education are using to avoid confronting the real issue behind the struggle of minority students in the classroom. Remember, these are the kids who have from day one have had Early Childhood programs, Head Start, 4-year old kindergarten, full-day five-year old kindergarten, SAGE classrooms with lower student-to-teacher ratios, English as a Second Language programs, before school programs, after school programs, summer school programs, free and reduced school lunch, free school breakfast, summer breakfast and lunch programs and reading specialists at all grade levels--and they still aren't making the grade.
With taxpayers who have funded all of the above programs growing tired of being told they are the reason for these failures, those in education are now (unfairly blaming the teachers. All in a continuing effort to avoid pointing the finger at the greatest source of minority failure--a lack of accountability on the part of parents. The opportunity to learn and break out of the cycles of poverty and crime are provided 180-days a year in even the worst neighborhoods in America--staffed by people who truly care about the children they serve--regardless of their "socio-economic background". It's about time those who wield the greatest influence over those children make it a priority to take advantage of those opportunities.
So why then are we so accepting of the very same argument for poor performance by minority students in Wisconsin? Superintendent Tony Evers has formed a task force to address the performance gap--and it's chairman stated on Upfront With Mike Gousha that one of the issues is that white teachers "don't relate" to black students. In our own interview with Oshkosh School Superintendent Stan Mack last week, he called having a teachers with a "99% middle class white background is a 'problem'".
This of course begs the question of what difference race makes in knowing that 2+2=4. And I'm pretty sure that George Washington was the first US President for blacks as he was for whites. Of course, kids aren't asked straight-forward questions like that or their tests anymore. Instead the questions are all word problems (Sally has two seasons of Game of Thrones downloaded on her IPad and two seasons of the Walking Dead. How many seasons of shows can she watch since kids aren't expected to do homework anymore?) Or they ask kids how they "feel" about things (George Washington owned slaves, how do you think that makes African-Americans feel when they see his picture on the dollar bill?)
The "racial teaching disparity" is just the latest excuse those in education are using to avoid confronting the real issue behind the struggle of minority students in the classroom. Remember, these are the kids who have from day one have had Early Childhood programs, Head Start, 4-year old kindergarten, full-day five-year old kindergarten, SAGE classrooms with lower student-to-teacher ratios, English as a Second Language programs, before school programs, after school programs, summer school programs, free and reduced school lunch, free school breakfast, summer breakfast and lunch programs and reading specialists at all grade levels--and they still aren't making the grade.
With taxpayers who have funded all of the above programs growing tired of being told they are the reason for these failures, those in education are now (unfairly blaming the teachers. All in a continuing effort to avoid pointing the finger at the greatest source of minority failure--a lack of accountability on the part of parents. The opportunity to learn and break out of the cycles of poverty and crime are provided 180-days a year in even the worst neighborhoods in America--staffed by people who truly care about the children they serve--regardless of their "socio-economic background". It's about time those who wield the greatest influence over those children make it a priority to take advantage of those opportunities.
Monday, May 5, 2014
Numbers Game
With all of the numbers swirling about the Affordable Care Act, it's getting harder to keep track of what has been "accomplished" by the new law. The White House tells us there were 8-Million sign-ups through the exchanges throught the extended, extended deadline. The Health and Human Services Department admits that 6-Million people had policies canceled because of standards contained in the ACA. The same Department claims 3.1-Million people under the age of 26 signed up for health insurance on their parents' plans--but that is actually a 2010 estimate of how many people could enroll that way--no actual numbers have been produced to support that claim.
Over the weekend in an interview with NBC, House Minority Leader Nancy Pelosi claimed 15-million people had "gained coverage" since the ACA went into effect. Representative Pelosi must have access to numbers that no other source has been provided with yet. Perhaps she has inside knowledge of how many people were covered in state Medicaid programs, or she saw employment data of people who were hired by companies offering private health insurance. Either way, 15-million is a far cry from the 30-Million figure that she used tirelessly to quantify the number of people "desperate" for health insurance in 2010.
Another new number over the weekend was the 248-Million dollars the state of Oregon spent in setting up their own health care exchange, only to admit that it will never work properly--and that next year, everyone will have to register through the Federal exchanges. You may recall, President Obama took (mostly) Republican governors to task for not setting up their own exchanges--forcing more people to use the inoperable healthcare.gov website to sign up for policies. Imagine the $1000-per-person-signed-up cost of Cover Oregon applied to all fifty state budgets.
And then over the weekend we learned that only 2/3rds of all healthcare.gov "enrollees" had actually paid their first month's premiums. I'll admit, that was actually much higher than I expected. If you had asked me to make a prediction on how many people had actually paid for their new policies, I would have put it at 1/3rd. But the real important numbers--and hopefully they will actually be tracked (you never know with this administration)--will be how many people keep paying the premiums.
There is a very easy way to game the system here. The deadline for enrollment--in order to meet the Individual Mandate--will be February 15th from now on (barring Obama Administration extensions without Congressional approval). Some of the insurance companies in the exchanges are giving enrollees up to 60-days to make that first payment--while still getting "coverage". That means a person who goes to healthcare.gov can sign up for a policy--get their number, which must be provided on their income tax return (since the IRS is the "enforcement agency" for the individual mandate)--and file their 1040 showing that they are "legally covered" all without spending a penny. Math nerds--like Paul Ryan--probably have their graphing calculators ready to work out the charts that will show a rollercoaster-like pattern of enrollees before April 15th and the subsequent drop following tax day.
Those who love the ACA will tell you that it's "not about the numbers"--and that if even "one person now has health insurance it's all worth it". But if you are going to have a sustainable program, the numbers have to line up eventually. As I always like to say, Math always wins.
Over the weekend in an interview with NBC, House Minority Leader Nancy Pelosi claimed 15-million people had "gained coverage" since the ACA went into effect. Representative Pelosi must have access to numbers that no other source has been provided with yet. Perhaps she has inside knowledge of how many people were covered in state Medicaid programs, or she saw employment data of people who were hired by companies offering private health insurance. Either way, 15-million is a far cry from the 30-Million figure that she used tirelessly to quantify the number of people "desperate" for health insurance in 2010.
Another new number over the weekend was the 248-Million dollars the state of Oregon spent in setting up their own health care exchange, only to admit that it will never work properly--and that next year, everyone will have to register through the Federal exchanges. You may recall, President Obama took (mostly) Republican governors to task for not setting up their own exchanges--forcing more people to use the inoperable healthcare.gov website to sign up for policies. Imagine the $1000-per-person-signed-up cost of Cover Oregon applied to all fifty state budgets.
And then over the weekend we learned that only 2/3rds of all healthcare.gov "enrollees" had actually paid their first month's premiums. I'll admit, that was actually much higher than I expected. If you had asked me to make a prediction on how many people had actually paid for their new policies, I would have put it at 1/3rd. But the real important numbers--and hopefully they will actually be tracked (you never know with this administration)--will be how many people keep paying the premiums.
There is a very easy way to game the system here. The deadline for enrollment--in order to meet the Individual Mandate--will be February 15th from now on (barring Obama Administration extensions without Congressional approval). Some of the insurance companies in the exchanges are giving enrollees up to 60-days to make that first payment--while still getting "coverage". That means a person who goes to healthcare.gov can sign up for a policy--get their number, which must be provided on their income tax return (since the IRS is the "enforcement agency" for the individual mandate)--and file their 1040 showing that they are "legally covered" all without spending a penny. Math nerds--like Paul Ryan--probably have their graphing calculators ready to work out the charts that will show a rollercoaster-like pattern of enrollees before April 15th and the subsequent drop following tax day.
Those who love the ACA will tell you that it's "not about the numbers"--and that if even "one person now has health insurance it's all worth it". But if you are going to have a sustainable program, the numbers have to line up eventually. As I always like to say, Math always wins.
Friday, May 2, 2014
Secession Talk
This weekend, the Republican Party of Wisconsin will have to go through the embarrassing task of having to vote on a platform measure re-affirming the state's right to secede from the United States. The idea comes from the nutjob Tea Party wing, which seems to have adopted the "leave it" part of the old saying "America, love it or leave it."
Nevermind that President Abraham Lincoln established a precedent for preservation of the Union at all costs by declaring war on the Confederate states that seceded 150-years ago. And nevermind that leaving the Union would require a state to develop its own currency, border patrols, highway funding system, veterans administration, air traffic control network and military. And nevermind that everyone who still wanted to remain a citizen of the United States would immediately flee--decimating the tax base and workforce to such an extent that an "independent" state would be doomed to near-immediate third world status.
What I find interesting is that the "Republicans" pushing the secession issue are the same folks who like to portray themselves as Super Patriots. They claim to love America so much that they have to say the Pledge of Allegiance then sing the National Anthem AND God Bless America before they can start any of their rallies. They are also the ones that fly multiple US flags outside their house, and the one in their side car window and they have the flag pin lapel on every shirt and jacket they own.
Yet when things turn a little Socialist in Washington, they want to bail on the whole thing--take their football (or their state in this case) and go home--rather than properly engaging in the system and working for change.
You don't like Common Core standards and kids learning that there are no "right or wrong answers" to anything anymore? Then run for your local school board and tell your neighbors why modern teaching techniques are leaving us a nation of morons. Can't stand government overspending and debt? Campaign for your local city council or county board and get the taxes that people recognize the most reduced. This is the approach that liberals adopted 30-years ago when they got tired of getting their brains beat in every national election--build from the bottom up and people won't notice the change going on around them.
"Grassroots politics" is more than just standing in a park every few months, waving flags and yelling in a bullhorn. I'll grant you that its harder work than just pouting in the corner and threatening to leave the country--but it will certainly be more effective in the long run.
Nevermind that President Abraham Lincoln established a precedent for preservation of the Union at all costs by declaring war on the Confederate states that seceded 150-years ago. And nevermind that leaving the Union would require a state to develop its own currency, border patrols, highway funding system, veterans administration, air traffic control network and military. And nevermind that everyone who still wanted to remain a citizen of the United States would immediately flee--decimating the tax base and workforce to such an extent that an "independent" state would be doomed to near-immediate third world status.
What I find interesting is that the "Republicans" pushing the secession issue are the same folks who like to portray themselves as Super Patriots. They claim to love America so much that they have to say the Pledge of Allegiance then sing the National Anthem AND God Bless America before they can start any of their rallies. They are also the ones that fly multiple US flags outside their house, and the one in their side car window and they have the flag pin lapel on every shirt and jacket they own.
Yet when things turn a little Socialist in Washington, they want to bail on the whole thing--take their football (or their state in this case) and go home--rather than properly engaging in the system and working for change.
You don't like Common Core standards and kids learning that there are no "right or wrong answers" to anything anymore? Then run for your local school board and tell your neighbors why modern teaching techniques are leaving us a nation of morons. Can't stand government overspending and debt? Campaign for your local city council or county board and get the taxes that people recognize the most reduced. This is the approach that liberals adopted 30-years ago when they got tired of getting their brains beat in every national election--build from the bottom up and people won't notice the change going on around them.
"Grassroots politics" is more than just standing in a park every few months, waving flags and yelling in a bullhorn. I'll grant you that its harder work than just pouting in the corner and threatening to leave the country--but it will certainly be more effective in the long run.
Thursday, May 1, 2014
If It's White, It Must Be Racist!
As happens nearly every time we have a controversy involving race in this country, the so called "progressive thinkers" get out the biggest brushes they can paint as many people as the villains as possible. Stepping up to the plate to fill that role in the Donald Sterling controversy is Los Angeles Times columnist Sandy Banks who decided to spread a little collateral damage to the National Hockey League and it's fan base. In her article this week Banks had this suggestion for the soon-to-be-former-owner of the LA Clippers:
Let the real estate magnate and Clippers owner take his millions and buy a hockey team. Then he won’t have to worry about black superstars showing up for games on his girlfriend’s arm.
See, hockey is "safe" for racists because there aren't any black people there! (Which would come as a big surprise to the dozens of blacks and other minorities currently playing in the NHL--including two on the Anaheim Ducks--a team that Banks' newspaper gives marginal coverage to--not to mention the various ethnicities you will find at Toronto Maple Leafs and Vancouver Canucks games.)
Yes, minority participation in hockey is much smaller than any of the other major sports. But when your best players come from places like Parry Sound and Brantford, Ontario or Russia and Sweden--and work their way to the NHL through places like Brandon, Manitoba and Grand Forks, North Dakota--achieving diversity is going to be a challenge.
Believe me, the NHL and USA Hockey have made efforts to reach out to minorities. There are urban hockey youth programs that provide donated equipment and free ice time in an effort to offset what is usually the biggest factors in non-participation in the sport by kids of all colors--it's a very expensive game to play. But such efforts can only do so much. Barring passage of a federal law saying you MUST play hockey (like you MUST purchase health insurance) or the institution of some kind of racial quota on every team on every level--it will be up to minorities themselves to join the sport and increase the diversity.
But to people like Sandy Banks and others that see anything with majority of white people involved, there must be racism present. Maybe in her next column she can suggest Donald Sterling sponsor a PGA golf tournament or start his own NASCAR team.
Let the real estate magnate and Clippers owner take his millions and buy a hockey team. Then he won’t have to worry about black superstars showing up for games on his girlfriend’s arm.
See, hockey is "safe" for racists because there aren't any black people there! (Which would come as a big surprise to the dozens of blacks and other minorities currently playing in the NHL--including two on the Anaheim Ducks--a team that Banks' newspaper gives marginal coverage to--not to mention the various ethnicities you will find at Toronto Maple Leafs and Vancouver Canucks games.)
Yes, minority participation in hockey is much smaller than any of the other major sports. But when your best players come from places like Parry Sound and Brantford, Ontario or Russia and Sweden--and work their way to the NHL through places like Brandon, Manitoba and Grand Forks, North Dakota--achieving diversity is going to be a challenge.
Believe me, the NHL and USA Hockey have made efforts to reach out to minorities. There are urban hockey youth programs that provide donated equipment and free ice time in an effort to offset what is usually the biggest factors in non-participation in the sport by kids of all colors--it's a very expensive game to play. But such efforts can only do so much. Barring passage of a federal law saying you MUST play hockey (like you MUST purchase health insurance) or the institution of some kind of racial quota on every team on every level--it will be up to minorities themselves to join the sport and increase the diversity.
But to people like Sandy Banks and others that see anything with majority of white people involved, there must be racism present. Maybe in her next column she can suggest Donald Sterling sponsor a PGA golf tournament or start his own NASCAR team.
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