The hook brings you back

The group Blues Traveler had a huge hit with a song called “Hook,” which intentionally says nothing of substance. The chorus is as follows:

“Because the hook brings you back
I ain’t tellin’ you no lie
The hook brings you back
On that you can rely”

The song is about their frustration with MTV or popular music which relies on a “hook” to grab your attention. A hook is a catchy riff, phrase or gimmick used by songwriters. The Blues Traveler song is a tongue-in-cheek criticism of the use of a “hook” while using one.

To me, this song is a metaphor for companies selling products harmful to people’s health. The “hook” is an addiction, that brings people back to buy more.

The vaping industry is repeating the successful sales model of selling smoking to kids and young adults to get them hooked. The tobacco industry knew dating back to 1964 that nicotine was addictive. So, they hid this fact as they added more nicotine. The subterfuge lasted until the mid-1990s when an insider blew the whistle. This was after eight tobacco CEOs sitting at a table in front of a Congressional Committee lied saying nicotine was not addictive. What is troubling about the vaping industry is they are selling these vapes as candy in all kinds of flavors.

An even more dramatic and traumatic sales job relates to the opioid pain killer business. These companies were not forthcoming about how addictive their product is. People have died and families have been ruined by this subterfuge. And, once again we have a heroin and worse drug addiction problem in America, as it is cheaper than the opioid product. Please strongly consider non-opioid painkillers if you have surgery or an injury, if permissible by doctor.

On a more widespread basis, food companies have asked their chemists to make their products more addictive. How? By adding more sugar to their products. The sweeter taste is more alluring and gets people to eat more and buy more. What is the harm in a little more sugar? The US is the most obese country in the world and kids are now getting adult diabetes, not just juvenile diabetes.

So, like catchy songs, these hooks are designed to sell lots of products to unsuspectingly addicted consumers. Please be mindful of when you buy to make sure you are not being reeled in.

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Unsurprising news

The Associated Press reported today the US deficit for the first ten months of the 2018-19 fiscal year has increased by 27% over last year’s ten month deficit. The $867 billion deficit is in line to pass $1 trillion for the year ending September 30, 2019.

This is not a surprise as the tax law passed in December, 2017 is projected to increase the debt by $1.5 trillion over the next ten years. That is on top of the expected increase without change of $10 trillion. And, to make matters worse two spending bills in 2018 and 2019 have increased spending, with the latter increase yet to be felt.

Expenses are up 8% and revenue is up only 3% with such a good economy. As mentioned before, we should be paying down the debt in good times, but the tax bill reduced the revenue from where it would have been.

Politicians, including this president, have an unhealthy focus on short term results. The long term impact can be blamed on future politicians, in their minds. We have a ticking time bomb, where our $22 trillion debt will be closer to $35 trillion in ten years sans change.

Some poor president and Congress will have to step up to solve this problem. And, they will unfairly get blamed.  It will take both spending cuts and tax increases to get us there. And, to show how frustrating harmful action is, a Senator from Florida yesterday said we need a tax cut to spur the economy with the pending recession – really? More debt is the answer?

We need fiscal stewardship and leadership. We are not getting it from these incumbents. And, that is a dereliction in duty.

 

Helping people climb a ladder – a perspective

The following is an edited version of a comment on Hugh Curtler’s (a retired college professor of philosophy) post regarding whether we should help people in need or let them fend for themselves. I provide a link below to his post. I am going to cite the work a charity I used to be a part of that builds off the book “Toxic Charity,” written by a minister who lived with the disenfranchised people he sought to help. His name is Robert Lupton.

Lupton’s thesis is simple: true charity should focus on emergency or short term needs. What he argued for to help others long term and we did (and still do) is help people climb a ladder back to self-sufficiency. That should be the goal. An easy example is he would advocate for food and clothing co-ops rather than giving the food and clothes away. People love a bargain, so let them maintain their dignity while they get discounted help. This dignity thing is crucial – people would rather not have to ask for help.

Note, we cannot push people up the ladder. They must climb it.  A social worker I have advocated with used to say “we walk side by side with our clients.” The folks we helped are homeless working families. We had two keys – they received a subsidy for rent based on their ability to pay, but they had to plan, budget, get financially educated working with a social worker and attending required training programs. Our homeless clients had to be responsible for rent and utilities up to 30% of their income, which is threshold for housing risk. Another key is we measured success. Success to us is being housed on their own without help after two  years.

As a community and country, we need to better identify what we mean by success in our help for people in need. Also, are things like healthcare a right? Is food on the table a right? Is a roof over the head a right? What we need is better measurement of what we spend and how it helps. It actually is cheaper to provide housing to chronic homeless and partially-subsidized housing to those who are more acutely homeless (due to loss of job, reduction in hours,  loss of healthcare, problems with car, predatory lending on a car, etc.) than let them go to the ER or commit petty crimes and be jailed. People should know all homeless are not alike, so the remedies to help need to vary.

My former party likes to argue off the extreme anecdotes – the significant majority of people do not cheat the system, but the perceived thinking of such is much higher in Republican ranks. When I have spoken to church groups, chamber groups, rotary clubs, United Way campaigns, etc., I come across this bias which is firmly believed. Just last month, the US president announced curtailing a rule on food stamps which will put 3 million people at risk, as one man was able to purposefully game the system. Yes, there is a small percentage of folks that do that, but the significant majority do not.

What people like David Brooks, a conservative pundit, tout is a dialogue on what kind of country do we wish to be? Our economy is a fettered capitalist model, with socialist underpinnings to help people in need and keep people out of poverty. What is the right balance? Is it better to pay a much higher minimum wage or have a higher earned income tax credit, e.g. Is it better to have a Medicare for All system, subsidize those in need or have a free market system only? A factor in this decision is many employers now employ a larger part-time or contractual workforce (the gig economy) to forego having to provide benefits. This is especially true in retail and restaurant industries.

At the end of the day, Gandhi said it best – a community’s greatness is measured in how it takes care of its less fortunate. With so great a disparity in the haves/ have nots in our country, I can tell you we are out of whack as our middle class has declined and far more of them fell into a paycheck-to-paycheck existence. Ironically, even in the age of Trump promises, we have many people who do not realize they are voting against their economic interests. Doing away with the ACA and not expanding Medicaid are very harmful to rural areas, e.g.

So, I agree with Gandhi, Lupton, and Brooks that we need to help people, but decide what is the best way. We should measure things and adjust them when they get out of whack. It is hard to fix what you do not measure. The group I was involved with would alter its model, if the numbers showed less success than hoped. What I do know is over 80% of the people we helped are still housed on their own after two years of leaving the program. In other words, they live without a subsidy.

Finally, what we need most is for politicians to check their tribal egos at the door when they enter the room. Having been a member of both parties, each party has some good ideas, but both have some bad ones, too. I do not care what a person’s party preference is or if he or she is more conservative or liberal than me  (I am fiscally conservative and socially progressive), we need to use facts and data to make informed choices. And, continue to measure the results making modifications, if needed.

Dilemma

Three brief environmental news stories

The following are three snippets from recent news stories on our environment. Two are focused on climate change, while the latter is focused on our global water crisis, which gets so little air time. Yet, when the World Economic Forum polls its members on the greatest long term risks facing our planet, the top two risks are the global water crisis and climate change inaction. It should be noted, climate change worsens the global water crisis, through faster evaporation of reservoirs.

California, four automakers defy Trump, agree to tighten emissions rules – by David Shepardson and Ben Klayman in Reuters on July 25, 2019

“Four major automakers said on Thursday they have reached an agreement with California on fuel efficiency rules, bypassing a Trump administration effort to strip the state of the right to fight climate change by setting its own standards.”

Note: The companies did not want the president to strip away the Bush and Obama intitated standards for improvement on fuel efficiency. Since California has the fourth largest economy, by itself, in the world, this agreement is important.

It feels like something out of a bad sci-fi movie’
A top climate scientist quit USDA, following others who say Trump has politicized science – by Helena Bottemiller Evich in Politico on August 5, 2019

“One of the nation’s leading climate change scientists is quitting the Agriculture Department in protest over the Trump administration’s efforts to bury his groundbreaking study about how rice is losing nutrients because of rising levels of carbon dioxide in the atmosphere.

Lewis Ziska, a 62-year-old plant physiologist who’s worked at USDA’s Agricultural Research Service for more than two decades, told POLITICO he was alarmed when department officials not only questioned the findings of the study — which raised serious concerns for the 600 million people who depend on rice for most of their calories — but also tried to minimize media coverage of the paper, which was published in the journal Science Advances last year.”

Note: This purging of data, suppression of reports and denigration and sidelining of climate change scientists should be raising red flags. Instead of arguing the veracity, the Trump administration is going out of its way to bury the findings of peer reviewed scientists. Why? What further troubles me is if Trump wants to “Make America Great Again,” why is he giving away a scientific expertise to other countries? I recall when President Macron of France extended an open invitation to US climate scientists.

Extreme water stress affects a quarter of the world’s population, say experts
Qatar, Israel and Lebanon top list of places with worst shortages, as climate crisis threatens more ‘day – by Emily Holden and Vidhi Doshi in The Guardian on August 6, 2019

“A quarter of the world’s population across 17 countries are living in regions of extremely high water stress, a measure of the level of competition over water resources, a new report reveals.

Experts at the World Resources Institute (WRI) warned that increasing water stress could lead to more “day zeroes” – a term that gained popularity in 2018 as Cape Town in South Africa came dangerously close to running out of water.”

Note: This is a huge problem, especially in drought prone areas like Texas here in the states. There are competing forces for water, drinking/ food preparation, bathing and washing clothes, agriculture irrigation, fracking, etc. that are exacerbated by increasing populations and climate change. There has also been poor water management in too many areas. Better piping would help, using plants that are more endemic to an area use less water, moving away from fracked natural gas, planning the sources of water to save them, addressing climate change, etc. would help.

I like using this item as it came from an unexpected source – a Duke Energy spokesperson let it slip that they factor into their models an additional 11% evaporation loss from their water reservoirs due to climate change forecasts. If climate change is a hoax, why would one of the largest utilities in America be modeling that?

These three stories highlight that we must plan and do things now, before it is too late. We lost eight years under the Bush administration and have lost about two and half years under Trump to leverage federal climate change action. Bush had a petroleum lobbyist as his White Council on the Environment and Trump has a coal lobbyist as head of the EPA. Plus, Bush’s Vice President was a former petroleum CEO and who had a heavy hand writing in the 2005 Energy Act that fracking need not be subject to the requirements of the Safe Drinking Water Act and Clean Air Act. Why?

Why are such great pains being taken to suppress reports, data, laws and scientists? Why would not someone who claims all of this hoax not use fact-based arguments to counter? And, if that is not enough, the Trump administration prevented the authors of a multi-agency report on the risk of climate change from testifying in front of Congress to keep their testimony out of the public record.

 

Blue Cross Blue Shield of North Carolina ACA premium rate cut request

Earlier this week, Blue Cross Blue Shield of North Carolina (BCBSNC) has announced a request of a premium rate cut for the second year in a row under the Affordable Care Act. They announced a request of a 5.2% rate reduction for their 435,000 members and one of 3.3% for small businesses in the state. It would have been three years in a row, but as I mentioned in earlier blogs, the Trump decision to renege on paying insurers for absorbing co-pays and deductibles for people making less than 2 1/2 x poverty limit caused premiums to increase for all.

This shows the ACA is stabilizing for insurance carriers who have been at it a few years. It would be nice to get more carriers back in for members to have choices. Many left when the Senate, led by the GOP defunded the risk corrider payments to the tune of 89% of the adverse selection cost. These carriers left the markets with the US government owing them money.

These two efforts to dampen the ACA have gone largely unreported. But, there is one more which is critical that impacts premiums and threatens the entire ACA. The tax bill passed by the GOP led Congress eliminating an unpopular feature of the ACA, which required individual coverage. It was called the individual mandate. By obligating people to have coverage, it lessened the risk on the insurers which will keep premiums lower than they would be otherwise.

Here is what BCBSNC said in their announcement as reported by The Charlotte Observer.

“The rate of decrease requested for 2019 would have been larger, the company told the Observer in 201, if the GOP tax reform legislation signed by President Donald Trump hadn’t repealed the ACA’s individual health insurance mandate.”

Further, several GOP led-states are suing the federal government to rule the ACA unconstitutional due to the elimination of the mandate. The tax laws are complex, but it is going to end up at the Supreme Court. It is thought by experts this case is weak, but the Trump Justice Department has decided to not defend the law which helps so many. Ironically, this is happening as it stabilizes even more, the GOP lost seats because of their ham-handed efforts to repeal it and when some Democrats want Medicare-for-all.

A plea for progressive Democrat voters

The following plea is made by an Independent voter who has been a member of both parties. I am fiscally conservative and socially progressive. I am an advocate for the disenfranchised, environment and debt education. What all this means is I believe in helping people climb ladders, equal opportunity and rights, protecting our environment, but recognizing we have to pay for things.

My plea for progressive Democrat voters is as follows: If someone

  • cares about our global reputation and trade,
  • cares about good healthcare options,
  • cares about fighting climate change,
  • cares about protecting the environment and bee pollinators,
  • cares about our growing debt problem made worse by this president,
  • cares about civil rights and liberties for all,
  • cares about common decency,
  • cares about data-driven analysis, and
  • knows that our economy has been growing for over 120 months, only 30 of which have been under this president,

then please vote for Donald Trump’s opponent.

But. you must vote and not phone it in. Trump won in 2016 because he got people who were not crazy about Hillary to stay home or vote for Jill Flynn.

As for the Democrats – beating Trump truly is the major consideration. He is a clear and present danger to our democracy, our planet and even his own party. Please do not nominate a candidate that will not appeal to moderate Dems and Independents. Trump should not win this election if Dems do this. He can win if he continues to resonate with his race baiting and fear mongering of perceived evils of socialism and Dems nominate a George McGovern or Walter Mondale like candidate (please research how they did in the general election).

I am writing this to any progressive readers. We cannot be stupid about this election. Trump is beatable, but he can also win. Watergate was all about making sure Nixon ran against McGovern and not Edmund Muskie and getting dirt on McGovern once they got Muskie to drop out of the race (please research Nixon’s dirty tricks and Muskie’s tears of anger). Trump is more corrupt than Nixon, per conservative writer George Will – I agree. He will do everything in his power to lie, cheat and bully. Take that to the bank.

Finally, a note to all Democrat candidates – get every fact you can correct. Trump uses facts and truth as commodities – sparingly and only when they help him. But, even then he is prone to embellish his own role in good news. Fact-checkers have reported all candidates fudge the truth, but they also show no one comes close to Trump’s rate of lying. Do not be like that. Argue facts, diplomatically and forcefully. And, if anyone or group promotes violence in reaction to the hateful rhetoric, be quick to condemn it. Violence has no place in political discourse.

Please stabilize the Affordable Care Act NOW to help Americans

A February, 2017 Morning Consult Poll noted that 35% did not know the Affordable Care Act (ACA) and Obamacare are the same thing. I want you to think of this poll when you see how Americans feel about the ACA. Today, just under half of American approve of the ACA, but that is in part due to the above and the fact more progressive Democrats want a Medicare-for-All replacement.

I wrote the following post a few months back as I am of the opinion Democrats and Republicans need to stabilize the ACA now and explore a few changes on a measured basis. As I wrote this, I call politics on the carpet for causing some of this mess, but everyone needs to check their egos and zero-sum games and fix the problems which are fixable. They also need to drop the BS lawsuits that are asking to rule the ACA unconstitutional again, when the group making the request changed a feature to further this mission. That is like ripping an engine off the plane and blaming the engineer while it is flying.

So for what it is worth, here are my suggestions. I am an Independent voter and retired, but my career included being an actuary, benefits consultant and benefits manager for a Fortune 500 company. I have shared with Senators and Congressional representatives a few thoughts on stabilizing the ACA, something Democrats campaigned on last fall and won in the midterms after the disastrous attempts of the Republicans to clean the slate that fortunately failed.

Medicare-for-All deserves debate, but will require a more elongated and data-driven discussion. We need to have Congress take steps to stabilize the ACA now. To do otherwise, is a disservice to Americans.

Here are my thoughts.
– the GOP sabotaged the ACA in two specific steps which increased premiums even more. They defunded 89% of the risk corridors (for initial adverse selection) driving some insurers out of the market. The other is Trump reneged on reimbursing insurers for copays/ deductibles for people making less than 2 1/2 times the poverty level. My suggestion is to pay insurers what we promised in writing and invite those who left back into the exchanges.*

– I suggest the lowering of the eligibility age for Medicare to age 62 (the age when retirees can first draw Social Security). This could be viewed as a pilot for Medicare-for- All. This action would lower the Medicare premium rate for all and lower the ACA exchange premiums due to the age of those leaving the ACA and joining Medicare. In other words, both the average age of Medicare and the exchanges would be lower, so the actuarial cost per person is less in both.

– Actively encourage the expansion of Medicaid in the remaining states – this will help the economies, healthcare providers and people in those markets. There are now 36 states who have done so. GOP Ohio Governor John Kasich calls Medicaid expansion a “no brainer.” North Carolina is debating this issue, but it needs to move forward with the number of rural hospitals that have closed thus far in the state.

– Finally, where only one option exists in a rural county, offer a Medicare option, again as a pilot. People should have choices.

There are other changes that would help, but this needs a data-driven analysis and not whatever the GOP did in 2017, which was a horrible approach to legislation that resulted in horrible legislation. Had any of the GOP legislation passed to kill the ACA, the GOP would have lost even more seats and we would be talking about a recession coming our way.
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* Please feel free to Google these topics: “Marco Rubio and risk corridors” and Donald “Trump and ACA subsidy decision”. The former caused insurance premiums to increase more than they otherwise would have and some insurance companies left the exchanges with the US government owing them money. The risk corridors were designed to tie insurers over until the initial adverse selection flushed out of the system.

The latter was frustrating because the subsidy helped people in need. Trump untruthfully claimed it will only affect insurer profits, but the carriers committed to the customers to do this under contract. The CBO said this action raised the deficit by $10 billion, since premium subsidies went up to pay for the increased premiums. In my home state of NC, BCBS said before the Trump decision premiums were NOT going to increase. After the decision, the premiums increased 8%.

Saying this in a more succinct way, the GOP screwed American people to win a political argument. Sadly, that is the truth, but very few people know of this. This also is an exemplar of the President’s lying affecting hard-working people. Lying is one thing, but setting policy off lying is another matter altogether.

Note, the ACA is imperfect and complex. Obama was not truthful when he said you could keep your doctor – no new network should make that universal claim. But, it still has not been fully implemented in all the states with those who did not expand Medicaid. But, people need to be fully aware of the sabotaging of the ACA undertaken by the GOP, which I find interesting, as the ACA is largely based on a GOP idea. That is politics for you – you did it, so I must be against it.