A few suggestions on ACA Reform

Since the House and 13 Senate Republicans have decided not to listen to the American majority or review actual data, here are a few suggestions on reforming the ACA. The ACA is imperfect and seeing higher premiums than expected in some places, but critics overlook three key things. It has dramatically reduced the number of uninsured, it has introduced positive benefit requirements to all plans including employer sponsored ones and its premiums are even higher due to Republican Senators stiffing insurers.

What should we do about improving the ACA? First, do not pass any variation of the ill-conceived AHCA bill passed by the House. It is obvious the gang of thirteen GOP male Senators are not listening to the American majority. For what it is worth, here is what this retired benefit consultant, actuary and manager suggests for consideration.

– Pay insurers for the amounts promised them under the ACA to take on initial adverse risk (as was done when Medicare Part D was rolled out) and invite them to stay or return to the exchanges. Part and parcel with this change is to restore the risk corridor funding for adverse selection going forward. This will bring premiums down.

– Fully expand Medicaid in the remaining 19 states. The National Governors Association advocates the positives of Medicaid expansion with Ohio Governor and former Presidential candidate John Kasich calling it a “no brainer.” This will help rural hospitals, economies and residents as well as others in more urban settings.

– Reduce eligibility to Medicare to age 62. This will reduce the overall risk profile under the exchanges and Medicare since the added Medicare population is older than the average exchange population it would leave and younger than the Medicare population it would be joining.

– Where competition in the exchanges is nonexistent with only one provider, offer a public option through Medicare or a variation therefrom. The pricing needs to be fair when contrasted to the lone offering as you want provide viable choice, but not drive the lone insurer away

– Finally, I would suggest we evaluate the efficacy of all fee arrangements under the ACA. Which ones make sense to continue, which ones make sense to alter, and which ones should be shelved or replaced?

It would also be helpful for naysaying for the sake of a party position to cease. Some impressionable people have refused to consider the ACA because a politician told them not to saying it was horrible or in a death spiral. People need to be mindful that health care and insurance are complex and politicians are offering advice in areas for which they are not licensed or knowledgeable to do so.

To be frank, I would rather see us go down the path of a national health insurance model. Yet, that is s tough sell in this country. So, improving the ACA is the better course versus what is being discussed. Plus, the strategic expansion of Medicare noted above will permit us to study this option and expand or contract it based on its measured veracity.

 

 

 

Is it thrifty or environmentally friendly

I have mentioned in the past I am both a tree hugger and capitalist. On the latter, I like to spend money wisely. But, it goes hand-in-hand with being environmentally friendly, as conserving resources is both cost effective and good for the environment.

My wife laughs at me as I will eat leftovers for several days. She will usually join in for one more meal, but she will abstain from further meals. It gives me satisfaction to finish food off. This is especially true as we as a country throw so much food away. And, I hate to throw food away.

We are also doing our best to drink filtered tap water. My wife tells folks my husband won’t let me buy plastic bottled water. She likes to tease me about things like this as many spouses do. However, I can assure you my wife won’t do anything unless she agrees with it. She understands this will keep from adding to the floating plastic in the Pacific.

We also live in an area of the city which is a couple of miles away from three shopping areas of various sizes. As I like to walk, I often will become a pedestrian shopper. It saves on gas emissions and gets me some needed exercise. And, since most car accidents occur within a mile from home, it helps me with the odds.

I mention these three things as they are easy things to do to save money and the environment.  I am sure each of us have things we could do that would save on both. What are some of your actions?

So, it is more than OK to be a little thrifty. Of course, my wife threatens me to not to turn into her mother who raised five kids on her father’s salary.

Monday, Monday

With this famous Mamas and the Papas’ song in my head, have the best of weeks. Here are a few random musings to start off the week.

The new sleight of hand approach being used by the US President on Russiagate is “It is his fault I cheated.” In essence, his predecessor chose not to make public the verified Russian meddling in the Presidential election due to the polarized political climate. While I understand his logic, I disagree with his silence. Yet, his choice does not alter the fact the newly elected President is at the very minimum an unwitting participant in the meddling and, as yet to be proven, a known colluder. Either way, he cheated, but that is consistent with his history.

Speaking of cheating, having clandestine discussions about health care reform does not give off the impression what you are doing is on the up and up. David Brooks, the conservative pundit, said on Friday that a key reason for the secrecy is there is no overriding mission to what is being done. Also, it could be construed as cheating to sabatoging the Affordable Care Act by not giving money promised to insurance companies to reimburse them for the initial adverse risk they took on. These actions harmed people as premiums went up even more and some companies left the market because they were stiffed.

The reason the “Black lives matter” movement started has been in evidence even more of late. Apparently, in terms of police shootings, they don’t. I would not want a police officer’s job as it is very dangerous. And, there are many, many fine officers. Yet, there have been too many actions taken that seem to fly in the face of reasonable use of force. Why must shots be taken? Why must so many shots be taken? Why must the shooter shoot to kill? When I see seven, twelve, sixteen shots are fired, I find that excessive. We must have honest review by all parties and better training. Too many Black men are dying and yes, their lives do matter.

These reflections turned quite sobering. I hope everyone stays safe and travels safely this week. And, don’t forget to hug your loved ones and tell them how you feel.

 

 

 

Use that filter before you speak

In my efforts not to curse, the above title is a euphemism for what I would prefer to say. My message is to those who have decided to bypass any filters and say the most inflammatory things.

Two public figures – Johnny Depp and Kathy Griffin – decided that they should make suggestions about the demise of the President. And, a Democrat official was appropriately fired for making a statement about how he was glad Representative Scalise was shot because of his role in passing unfavorable legislation.

There is no call for these comments or actions. I fully understand the President has incited, promoted and condoned violence against others. He has failed to call out violence against minority groups, but has a quick comment for when a Muslim may be the perpetrator. This is not right, either.

So, let me be frank. One set of actions does not condone the other. Further, being violent or speaking of violence makes one’s argument poor. It is hard to argue issues when these uncivil remarks and actions get in the way of dialogue.

We need to remember we are all Americans. That is the most important tribe. It is well within our rights to disagree with leaders and others, but please be civil. Treat others like you want to be treated. If you call someone an idiot, then you should not be surprised if they return the favor.

They said that?

One of the mysteries of politics is how politicians so easily forget a key point. Most of what they say is recorded. So, when they change a position, it can be shown they are at odds with their earlier views.

One of my personal favorites is both former Speaker of the House John Boehner and Senate Majority Leader Mitch McConnell are on video saying climate change is real and man-influenced and we need to do something about it. It should be noted that McConnell recently signed a letter with 22 senators saying we should withdraw from the Paris Climate Change Accord.

While on climate change, we should not forget the double flip-flop of former Speaker of the House Newt Gingrich. He first said it was a hoax. Then, he did a national TV commercial with former Speaker Nancy Pelosi saying he was wrong about climate change and we need to do something about it. Then he ran for President and said he was wrong to say he was wrong.

The sad part about the above is it did not do much harm to the three politicians. Others have not been as lucky. President George HW Bush was punished in a subsequent election after he promised “Read my lips, no new taxes,” and then later raised taxes. President Bill Clinton was impeached by the House for his lying under oath that “I did not have sexual relations with that woman.”

President Ronald Reagan was almost impeached when he lied on TV that he was not aware of weapons being sold to Iran to fund the Contras in Central America. He later went on TV and said he had misled America. And, President Barack Obama oversold the ACA saying that if you want to keep your doctor you could, without recognizing networks don’t work that way.

Yet, our current President has set a new standard for untruths and misstatements. They are rampant, occurring daily and sometimes hourly. When he recently said he would testify under oath, his attorney probably had a stroke. The attorney likely recalls how Trump testified under oath a few years ago and was forced to admit he lied 30 times.

Yet, let me conclude with a priceless quote from former Senator John Kyl which is indicative. When a reporter caught him in a lie, Kyl responded that “your problem is confusing what I said with the truth.” Yes, it is our fault for believing what you say.

Musings at the start of summer

The longest day in the Northern Hemisphere is upon us. Maybe with this extra daylight we can have more illumination on issues. It seems we have a bad habit in our country of governing off rhetoric rather real information.

Saying it more basically, we believe our own BS. It is puzzling why we would make decisions off stuff we made up. Yet, that gets to the heart of the matter. The authors of change don’t necessarily want to solve the problems. They just want to win the election game of optics.

A good example is the secretive Senate effort to develop a repeal and replacement bill for the ACA. The effort has several of the remaining Republican and all of the Democrat Senators up in arms. What is missing is open and honest debate. What is missing is open acknowledgement of Republican efforts to strangle the imperfect law by withholding money from insurance companies promised them to take on adverse selection (higher risk).

Another good example is withdrawing from the Paris Climate Change Accord where America abdicated a global leadership role. While the President and EPA Director tell us there is not consensus on man’s influence on climate change, they fail to tell us that there is an overwhelming consensus from the scientific community. They also fail to heed the recommendations of countless companies, cities and states to remain, including ExxonMobil and Royal Dutch Shell. The sad part is the job growth and investment in renewable energy is growing rapidly and large companies like Amazon. Google, IKEA, Walmart et al are leading the way.

Let’s hope our myopic leaders will use today’s extra sunshine to see the light.

Interesting contradictions per John Oliver

Our world is filled with interesting contradictions. It is especially apparent when people ignore facts or try to tell you other so-called alternate facts. Here are a few that I find amusing courtesy of John Oliver’s “Last Week¬†Tonight:”

– The Kentucky Museum on Coal is powered by solar energy. They save $13,000 per annum on energy cost using renewable energy.

– Scott Pruitt, the head of the EPA notes that 50,000 coal jobs have been created under this President, when there are only 76,000 jobs to begin with. The correct answer is 1,300 jobs, which is positive, but 48,700 lower than advertised.

– While coal energy CEOs like to blame President Obama, it should be noted coal jobs have been on the decline for decades. And, 50% of more recent job losses have been due to natural gas, 18% due to renewable energy and the rest due to technological improvements. That means 32% of the job losses are on the shoulders of the coal CEOs.

– As one coal company went into bankruptcy to reorganize, the CEO petitioned the court to allow him to cancel a non-union retiree medical and life insurance plan to save $3 million, but permit them to set up a retention bonus plan for management for $11 million.

– While the President has touted his interest in serving the needs of coal miners, his proposed budget eliminated funding for an Appalachian retraining program for displaced coal workers.

As Oliver points out, there is a huge distinction between actions that support the coal industry and actions that help coal workers. The President and others owe these coal miners the truth. Their jobs are going away and we need to work on career redevelopment.