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.

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An ostrich pulls his head out of the sand

This story should not be newsworthy as it is long overdue, but unfortunately it is. A headline from a USA Today last week proclaimed “Trump ally Lindsey Graham says president should ‘admit climate change is real’.” Senator Graham went on to say per the article:

“‘I’m tired of playing defense on the environment,’Graham told reporters on Capitol Hill Wednesday as he and other GOP lawmakers announced the formation of the Roosevelt Conservation Caucus, which will ’embrace and promote constructive efforts to resolve conservation and environmental problems.'”

I have written often about addressing climate change. Progress in fighting climate change is happening, but it desperately needs the leverage of the US federal government. Plus, we must alter harmful deregulation to our environment.

Rather than belabor these points, let me say I left the Republican Party about a dozen years ago, in part due to its stance on climate change. My thesis is if the GOP is going to play ostrich-with-its-head-in-the-sand on an existensial threat to our existence, how can I trust its judgment on other issues.

So, thank you Senator Graham for pulling your head out of the sand and asking the US president to join you. As an independent voter and parent, I take seriously the threats to our environment and agree the GOP needs to alter its path on these topics.

The Good and Bad

Several stories crossed my screen, so I decided to pair good and bad news items on related topics.

Good: Ford and Volkswagen are co-investing in developing electric vehicles sharing development costs.

Bad: In spite of the significant decline in bee populations, the Trump administration has approved a bee-harmlng pesticide.

Good: The American economy is now into its 121st consecutive month of growth with nine straight years of 2 million plus jobs created.

Bad: The 2019 economy has softened some from 2018 due to trade/ tariff concerns, slowing global markets, waning impact of the 2017 tax law, growing US debt, and increased uncertainty which impedes investment and it should slow even more as predicted by economists.

Good: The interest in space travel and exploration involves an increasing number of countries – Japan and China have gone to the moon, eg. That spawns more interest in science which is terrific.

Bad: With the heavy cost of space travel, why don’t countries share the burden as Ford and Volkswagen are doing above? There is a lot of dupication of effort requiring money that could be invested here on earth to address water, food and climate issues.

Good: In spite of the US announcing a withdrawal from the Paris Climate Change Accord, other countries, states, cities, investment groups, companies and innovators continue to execute ideas that are addressing the issue.

Bad: The US federal governmenf needs to do more, not less to abet these efforts. Yet, another concern is getting little notoriety – the global water crisis, which is made even worse by climate change. Another city in India of 5 million people is in dire straights as its reservoir has almost dried up.

We should celebrate the good, but address the bad. We seem to be ignoring too many signals. It is hard to move forward, if we only look in the rearview. mirror. Food, water, climate, debt are signaling needs that must be addressed.

 

 

 

The Land of Misfits (Fruits and Veggies)

On one of the Christmas movies, there was a land of misfit toys. Today, I read an article about a company named Misfits Markets called “A company that delivers ugly produce is coming to Charlotte,” by Rachel Chernaskey of CharlotteFive.com.

In the US, we throw away a significant amount of usable food. A good portion of that is misshapen, bruised and unloved produce that does not make the cut for grocers or restaurants. Misfits Markets is a subscription service whose “company’s mission is focused on alleviating the environmental impact of food waste,” per its CEO and founder Abhi Ramesh.

Per Chernasky, Ramesh said he was inspired when he saw a Pennsylvania farmer collecting 2,000 or so apples to toss away. This is not uncommon, as some farmers find it easier to toss the food rather than donate it. The time and expense of trucking it to the food bank, make it easier to toss it.

Misfits Markets sell weekly, seasonal boxes of food priced by family size. The boxes will include a seasonal mix of apples, bananas, beets, berries, celery, kale, lima beans, pumpkins, squash, yams, et al. For a family of two, the box is $19 plus shipping and for four it is $34 plus shipping.

This is a marvelous idea as it promotes sustainable commerce from waste. It addresses head on the path to just discard usable food and with the challenges facing farmers, it could make a difference to their bottom line. Please look into Misfits Markets. There are other companies doing this as well.

 

A few Sunday meanderings

Good morning one and all. I hope your weekend is going well. Reading the Sunday newspaper and a few stories online, I thought I might meander a little on this Sunday, typing in tune with cicadas chirping outside.

A simple concept with a lot of big numbers – Swiss scientists have confirmed that planting one trillion trees would be one of the least expensive ways to take carbon out of the air. They note there are 3.5 million square miles of available land to do so. In the documentary “Ice on Fire,” which I wrote about a few weeks back, planting and maintaining forests was one of several key options that we should do. The scientists note this will only work if we stop putting so much carbon there in the first place.

A British ambassador speaks the truth about the US White House – Per a CNN report as reported by AFP.com, “Britain’s ambassador in the United States has described President Donald Trump and his administration as ‘inept’ and ‘uniquely dysfunctional’, according to leaked diplomatic memos published by the Mail on Sunday. Ambassador Kim Darroch reportedly said Trump’s presidency could ‘crash and burn’ and ‘end in disgrace’, in the cache of secret cables and briefing notes sent back to Britain seen by the newspaper.”  This is not news to people who pay attention to the machinations of the White House incumbent. My prediction is this will be called fake news from a loser network by said incumbent.

A day in the life, two more shootings in my city – If we rewrote John Lennon’s portion of the famous song “A Day in the Life.” which blended two separate songs, the other by Paul McCartney, we might have the following:  “I read the news today, oh boy, about two more shootings in the city I live. One was shot in an expensive hotel corridor, while the others in a famous fast food chain.”  Recognizing I did a poor job matching words with the notes, the sentiment is valid. Maybe, we should just report when no one is shot in the city, as that would be more newsworthy.

False equivalences abound – This is a pet peeve of Bill Maher, with which I agree. When someone commits a series of poor behaviors or says inappropriate things, members of the supporting tribe will parade out a false equivalence that is intended to balance the scales. The past few years, these false equivalences are paraded out to show that the president is not the only politician who lies. While that is true, the president has lapped the field several times with his lies. He lies far more than he does not, he has been recorded with over 10,000 lies as president, and five former associates (not the media, not Democrats) have been quoted, one under the oath, that the president is not very truthful including, but not limited to, his attorney fixer Michael Cohen, his former Secretary of State Rex Tillerson, his former White Counsel Don McGahn, his former National Economic Advisor Gary Cohn and former attorney Thomas Wells. The latter noted “Donald Trump lies every day even about things of no consequence.”

Why does the last item matter so much? Just read the leaked correspondence of the British ambassador. We are not trustworthy because our president is not trustworthy. And, it is hard to solve problems and build relationships if you cannot tell the truth. The first step to solving a problem is admitting you have one. Climate change is a problem, but he tells us it is a hoax. Guns are part of our shooting death problems, but he won’t admit they are. He tells the children detention centers are well run. And, so on.

 

 

Go forth, be safe on the 4th

Happy 4th of July everyone! Be safe as you travel and as you celebrate with family and friends. Here are a couple of reminders.

– Alcohol, testosterone and fireworks do not mix. Adding dry hot summer days do not help the situation. I am reminded of my wife’s cousin who blew off several fingers.

– If driving, appropriate following distance will help avoid many car accidents. Tailgaters overstate their ability to stop a car, especially when following a truck they cannot see around. To be frank, that is the nicest description of a tailgater I can use.

– At large outdoor parties, be mindful of food left out on a picnic table too long. Food poisoning is not rare in these circumstances.

– Also be mindful of long afternoons of drinking, especially those fruity concoctions that mask how drunk you’re getting. You don’t want to have Uncle John going to a crowded ER after wrecking his vehicle.

– The entire group should be mindful of small kids near pools, lakes and oceans. It only takes a few seconds for someone to drown. Hosts need to make sure someone is watching if they cannot. See above about parents’ drinking – I have seen close accidents avoided that should not have gotten that precarious,

– Finally, do your best to avoid politics. If you must respond, try to stay within the white lines and say things like “I wish they would work together to solve problems” which is a safe way to make a statement and exit stage left.

Have a safe and enjoyable holiday and weekend. May the 4th be with you this July.

Weariness and Frankness

This independent voter is weary of people not addressing the obvious and rationalizing actions and behaviors that are less productive. Having been a member of both parties, a Democrat for about ten years of my early adult life and about twenty years as a Republican, I define myself as fiscally conservative and socially progressive. Both parties have some good ideas, while both have some bad ones.

So, let me be frank with my opinions, built off this foundation.

Democrats can defeat Trump, but they can also lose to him. Please study why George McGovern and Walter Mondale got shellacked in 1972 and 1984 and why Michael Dukakis and John Kerry lost in 1988 and 2004. It is not ironic that winning candidates Bill Clinton and Barack Obama were more moderate Democrats. Democrats cannot beat Trump without Independents and some Republicans. They could start by working now to address shoring up the ACA as they committed to do in the mid-terms and not waiting until 2021. Medicare for All is worth the discussion, but we need to address issues today, especially after the healthcare fiasco the GOP went through in 2017.

With that said, people need to look under the hood as to why more progressive Democrats have a few socialistic ideas. We should not ignore that the US economy is fettered capitalism with some socialist underpinnings. On the top end down, we have rules that govern collusion, monopolies, interlocking boards, insider trading, bankruptcy, etc. and on the bottom end up, we have socialistic programs that offer Social Security, Medicare, Medicaid, Workers Comp, and unemployment protections. Yet, the reason for their focus is America has a widened disparity between the haves and have nots. The key is to have a good debate as to how we address this disparity, not name-call ideas to win elections. Plus, this discussion must be done in the context of our huge debt and deficit problem (see below).

Seeing a dozen Oregon Republican state lawmakers leave the state to avoid voting for a Carbon Cap and Trade bill should be a clarion call. Cap and Trade used to be a GOP idea, but fossil fuel funders told them not to like it. We are facing a climate change crisis and voters must ask what candidates are going to do about climate change. Let me emphasize I left the GOP twelve years ago in large part due to its stance on climate change. Fortunately, climate change action is not waiting on head-in-the-sand politicians, but could be leveraged by more federal help.

My concerns are exacerbated as not only did the US president announce our withdrawal from the Paris Climate Change Accord, he asked the G20 this week to soften language on climate change. It should be noted this is in contrast to his businessman stance, where a few years ago Trump staff requested in writing the Scottish government give them permission to build a sea wall at one of his golf courses to hold back the rising seas due to climate change. The word you are looking for his hypocrisy. The other words are fossil-fuel funding.

An issue not being discussed is rising US debt and deficit. Both parties are to blame. Nonpartisan groups and the Simpson-Bowles Deficit Reduction Committee clearly state this problem cannot be solved with just spending cuts and tax increases – it must have both, as the math will not otherwise work. These groups also note the GOP tax cut in December, 2017 was imprudent. But, Democrat candidates speaking of tax increases to pay for new social programs are being imprudent, as well. We need tax increases and spending cuts to pay for the poor stewardship of their predecessors.

When America forgets its ideals, we become just another country. I hear we must be a nation of laws, but we are treating migrants like chattel and not following due legal process. There is a reason so many attorneys are volunteering their services to migrants. If we are concerned about illegal immigrants, punishing companies that hire them would limit the economic slavery that goes on every day. Yet, we should also recognize that these folks are doing many jobs Americans don’t want. So, a thoughtful, humane and fact-based solution is warranted rather than a political one. Both parties are to blame, but I hold this president to account for making a recurring problem much worse with his words and actions. He reneged on a bipartisan agreement sixteen months ago and the House never took up a bipartisan Senate bill passed in 2013.

Finally, if we are to be a nation of laws, we should be gravely concerned the country is being run like a mafia family. The White House incumbent is clearly making money off the presidency and favoring countries where he sees business growth for his empire. It greatly troubles me that is daughter and son-in-law are serving unvetted and unapproved roles in the White House, because the president values loyalty over competence and experience. Then, comes the lying, bullying and denigration of critics, allies, media, public servants, etc. I have long been concerned over his setting policy off his lies be it climate change, voter fraud, Russian influence, Saudi prince innocence, Iran nuclear deal, the ACA, environmental pollution, and so on.

There is so much more I could write about. We need Americans to pay attention to better news sources, question things, and push back on politicians asking what they intend to do about issues. We need Congress to remember their job of governance. I feel this president is a clear and present danger to our democracy, our planet and even the Republican party. We are a Republic, not a kingdom and certainly not a mafia-ruled domain.