A few straightforward suggestions to fight poverty

“If incarceration had come to define the lives of men from impoverished black neighborhoods, eviction was shaping the lives of women. Poor black men were locked up. Poor black women were locked out.”

The above quote comes from the Pulitzer Prize winning book “Evicted” by Matthew Desmond. Its subtitle is also telling – “Poverty and Profit in the American City.” The dilemma is we have a poverty problem that stretches from urban to rural America. Yet, it manifests itself daily in the eviction courts of American cities and towns, whether it is from apartments, houses or mobile homes.

The book speaks of how fragile the rental community is regardless of race, yet the black community tends to have a higher rate of exposure to evictions in urban areas. Unexpected expenses, transportation problems, and tragedies can push people paying a very high portion of their rent over the edge and out the door. Ideally, 30% of family income should be toward housing and utilities. Too many of these folks are paying well above that percentage.

It should be noted that there are other drivers of fragility. Some have opioid and other dependencies. Some are fragile due to too many children that stretch the budgets of even the best planners. Some are in downward spirals with unsupportive landlords. And, many of those unexpected expenses that arise are healthcare related.

What are some suggestions to remedy these issues? Based on my experience as a volunteer Board member helping working homeless families and my reading, I would like to throw out some ideas for consideration.

First, we need to talk more about it. America has a huge disparity in distribution of wealth which is not talked about enough by leaders. Where and to whom one is born are greater predictors of success as the American Dream  has waned for too many.

Second, we need to fund more family planning efforts not less. There is a high correlation between poverty and large families. When family planning is funded and birth control access and education are increased, poverty declines, system health care costs decline and abortions decline.

Third, more mechanisms to reduce evictions need to be in place and funded. Crisis assistance funds show success in helping keeping the electricity on and, when funded, reducing the number of evictions. Stopping homelessness (or fragility) before it starts can make a huge difference and will have a positive echo effect.

Fourth, we must invest in impoverished  areas making them more suitable for families both with opportunity and resources. In their absence, crime and other poor influences fill the void.

Fifth, while I have concerns about the new Tax law with its impact on debt and heavy emphasis on the wealthy and corporations, a huge opportunity was missed when we could have added an increase in the minimum wage tying it to automatic increases due to wage inflation. I worry that less money than expected by the law’s drafters will end up in the hands of workers.

Sixth, we must address our opioid crisis in America. To be frank, cutting access to healthcare and mental care insurance benefits are not the answer. We must stabilize access and cost of healthcare, yet opposite measures have been taken in the past few years under the guise of political gain.

There are many more ideas, but these will help. On the investing front, many locations have seen success with using historical tax credits leveraging private money. There is a concept called ABCD (Asser Based Community Development) which shores up or repurposes an deteriorated asset creating jobs.

But, first we need to talk about this real and pervasive problem.

 

 

 

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Contact your Senators, Congressperson and President

It would not be a surprise to know that the US Congress and White House are highly dysfunctional. They have long ago forgotten why they are there. It seems opinions of the donors and oligarchy are the only ones that matter. We need to make our voice louder and consistent. Irrespective of any party affiliation, we must cease with the tribal BS. The party you support does make mistakes, many of them. Don’t just accept them because they are made by folks in your tribe. And, if you think it is only the other party, think again.

Please call your Senators, Congressperson and President and tell them messages they need to hear.

  • Please do not pass a Tax Bill that favors the elite and tell us it does not do so. That is an insult and a lie.
  • Please do not pass a Tax Bill that increases our debt. It is expected by the CBO to go up by $10 trillion and will be over $30 trillion in 2027 without the Tax Bill. What do you plan to do about it?
  • Please do not support candidates that are legitimately accused by multiple women of sexual assault. If a party supports a candidate or incumbent who defames the office, they need to be chastised openly and continuously.
  • Please cease kowtowing to the whims of donors that get you to make less prudent decisions such as pulling out of the Paris Climate Change Accord or freeing gun rights even more, when we need to govern guns better.
  • Please work together to improve the Affordable Care Act and make it more sustainable, ceasing efforts to undermine the imperfect law.
  • Please support the rights of every American and cease beating up on the media. They are hard-working people who try to get it right. If they admit mistakes, that is a sure sign of good intent. We could learn from that.

That is all for now. Do call them. Emailing using their template is fine, but you will tend to get a form letter. If you leave an email, ask them to call you. THIS IS OUR COUNTRY! We need to take it back.

 

The President almost did something good, then…

People need to know that our President is not big into details, nor does he care to be. He is not very conversant on healthcare or the Affordable Care Act, for example. Yet, he almost slipped up and accomplished something good. Alas, he changed his position within 24 hours.

Just last week, he signed two executive orders to help healthcare in the US. Neither order would be very helpful and both will cause premiums to go up under the ACA. In fact, he said if we eliminate the subsidies for deductibles, co-pays and co-insurance on people making less than 2 1/2 the poverty level it would just hurt the insurer’s profits. That simply is not true, as our deficit would go up by $20 Billion per annum and people without subsidies would see premium increases.

But, while this was going on, Senator Chuck Schumer kept telling him about the bipartisan effort of Senators Lamar Alexander and Patty Murray that would stabilize and improve the ACA. Their efforts would restore the subsidies that Trump wanted to do away with. Insurers were pricing 2018 premiums higher sans these subsidies,

Trump encouraged Alexander while Schumer did the same with Murray. The President actually did the right thing, as Alexander and Murray were going about their business in the right way with hearings and committe meetings. This is how legislation should be done, which has been lost on our two Congress chamber leaders.

When Alexander/ Murray announced they reached agreement, the President was supportive. Alexander actually thanked the President for his role in making it happen. Yet, just after Alexander called to thank him, Trump changed his mind and now does not support it. Less than 24 hours had elapsed.

Of course, his support may change and Alexander/ Murray are not done yet, but Trump had a chance to take credit for helping Americans. This could have been a helpful major piece of legislation, which is missing from his tenure. Alas, he realized he would be helping the ACA and he had to destroy it. That is what he promised to his base. While imperfect, the ACA is not broken, but it does need improvements. If it eventually fails, it is on this President and Congress’ shoulders.

When is the right time?

We should mourn the loss of innocent American lives at the hands of one shooter. We should offer our prayers, thoughts and support to the victims, injured, caregivers and their families and friends. And, we should demand from our lawmakers to act like parents and grandparents and to stiffen our gun governance.

NRA funded politicians, who unfortunately include the leaders of the two chambers of Congress and the White House, say now is not the time to discuss gun control. When is the time? The NRA is likely horse whispering in their ears to stiff arm the gun control proponents until the crisis abates. Then, lip service will be given to the subject as it is defeated once again, given the NRA’s ability to highly mobilize its confederation of zealous followers, even though they are small in number.

Speaker Paul Ryan has noted that it is more than a gun issue, it is a mental health issue. Two comments – it is a mental health issue, but make no mistake about it, access to guns is an issue. As an aside, there is an obvious disconnect between saying it is a mental health issue and supporting legislation that would kick twenty million Americans off their health plans, which include mental health benefits.

Now is the time to address better gun governance. It is actually passed time. Gun homicide deaths per capita in the US dwarf that of other western and non-western countries. When suicides are factored in, we look even worse.

I have written multiple posts over the years about better gun governance. Before summarizing them yet again, let me add what I have mentioned before – it is a mental health issue, it is a civil discourse issue, it is a safe gun storage issue, it is a violent entertainment issue and it is a drug crime issue which has infiltrated places of poverty. On the gun control side:

– background checks on all weapon purchases are essential,

– elongated waiting periods are also key, as this will help with suicide prevention and give time for authorities to track purchases – the Las Vegas shooter bought 33 highly lethal weapons in one year,

– finger printed trigger mechanisms (or the like) would prevent accidental deaths by kids and teens,

– ammunition needs to be coded so that bullets used in crimes can be traced, and

– like the expired Brady Law (another NRA victory), automatic assault weapons (and devices to convert semi-automatic weapons) have no place in non-miiitary settings.

The sad truth is the significant majority of Americans want the first two items to occur. Yet, nothing happens. Not only that, actions have been taken to make it easier to buy guns (if mental health is a concern, why did this Congress take people on Social Security disability for mental health reasons off the watch list for gun purchases?).

Now is the time. And, when you hear people say “guns don’t kill people, people kill people,” the response is no “people with access to guns kill people. No gun, no gun death. No automatic weapon, fewer multiple gun deaths.

My former party does not know much about healthcare

The Graham-Cassidy Bill seems to be on its last legs, but these bills are like Jason – just when you think you kill the serial killer, he remains alive. This latest effort may be the worst bill by my former party, which I left in 2006. It is apparent to me that Republican leaders don’t know much about healthcare and don’t care to know or take the time to know. That includes the man in the White House who just wants to sign something that negates something Obama did. “Who knew healthcare could be so complicated?” he asked earlier in the year. The answer “Everyone, but you.”

Every bill either put forth by the Senate this year or passed by the House has been scored poorly by the Congressional Budget Office (CBO), has been not appreciated in polls and has been denigrated by medical and hospital associations. Not involving women, Democrats, experts and due process in the planning revealed a haphazard approach to legislation.The Graham-Cassidy Bill is the worst of the bunch as it places the burden, and eventually all of the financing, on the states. In a nutshell, the bill says we cannot figure this out, so we are punting it to you.

In addition to the tens of millions of Americans negatively affected by these bills, if passed, the authors make a concerted effort to kick people in poverty and near-poverty in the teeth. Since we have a poverty problem in America, these bills are especially cold-hearted. And, Graham-Cassidy gives states the right to do away with pre-existing conditions, which was incorrectly refuted by Cassidy after being called on the carpet by Jimmy Kimmel. Seeing protestors in wheel chairs at the Senate was telling.

Further, I have shared with Senators, Congressional Representatives and the White House, these bills would be dilutive to the economy. Standard & Poor said yesterday in their global report the Graham-Cassidy would harm the American economy by $240 Billion through 2027 and cause 580,000 job losses. In a nutshell, when people in need no longer have insurance, the trade-off becomes between food/ rent and medicine. So, less is spent in the market place which dilutes the economy.

Yet, let me emphasize one thing that has been raised by more than a few state Medicaid Directors and Governors. Building a new healthcare delivery system will take longer than the time given. In my view, it will take longer than even these folks are thinking about. In business and government, leaders tend to vastly underestimate the complexity to set-up administration of things. As President Obama found out, setting up healthcare exchanges was hard and initially failed to deliver.

This is an important observation about the Affordable Care Act. It is in place. It is not in a death spiral and it is not broken. From the lens of fewer uninsured, it has been successful. Yet, it needs improvements, but first it needs to be stabilized. Part of the reason for the latter is the GOP’s efforts to hamstring its success by defunding subsidies for adverse selection to insurers. Coupled with slow funding of other subsidies, nineteen states who did not expand Medicaid and general naysaying, the law has not been given full opportunity to be successful.

So, this retired benefits actuary, consultant and manager recommends the ACA be stabilized under some version of the bipartisan Alexander/ Murray Bill. Then all members of Congress can spend more detailed and thoughtful time in deciding how healthcare can be delivered going forward. My recommendation is they improve the ACA.

Lyin’ Eyes

The Eagles sang about infidelity in their popular song “You can’t hide your lyin’ eyes. And, your smile is a thin disguise.” I mention these lyrics because of the lack of fidelity to the truth exhibited by various politicians.

The comedian Jimmy Kimmel is being vilified by conservative news sources regarding his calling on the carpet Senator Tom Cassidy about his misrepresentation of what is included in the Graham-Cassidy Obamacare replacement bill. Based on fact checkers, Kimmel knows what is in Cassidy’s bill more than Cassidy does.

This would not be the first time politicians have lied about Obamacare. Obama oversold it saying you could keep your plan, which was at odds with most insurance changes. Yet, the lion share of the lying has been by Republicans. This law is imperfect and needs improvements, but it is not in a death spiral or is broken as portrayed by the GOP. The GOP has also not been forthcoming about their multiple attempts to hamstring the law at the expense of Americans increasing their premiums even more.

But, no US politician can lay a hand on the  greatest liar on record. This man has been measured by Politifacts as telling the complete truth only 5% of the time. When partial truthtelling or more is included, the rate increases to 31%. Saying it differently, this man lies 69% of the time, which is consistent with his rate of lying on the campaign trail. This man, of course, is the White House incumbent.

What I have noticed over the years, when politicians lie, the people who are most harmed are US citizens. The reasons and broadcast success rates for the Vietnam War were packed with lies. The sad truth is the percentages of those who died or were injured were much higher for African-Americans and poorer Americans. They bore the brunt of the lies.

Scrolling forward, when Trump and other politicians lie, people tend to die at higher rates. If the ACA is replaced as planned in GOP bills, more folks will be uninsured and  be at risk. By pretending climate change is not a threat or that governing environmental issues are less important than business leaders’ companies, people will die.

I recognize politicians have always lied, but never before at this rate or with such impunity. Our leaders dishonor the flag when they lie so much. And, they hurt our standing in the world. Right now, other world leaders do not trust Trump. They have good reason.

 

 

 

 

The President and Congress own Obamacare

I have written often about the imperfect Affordable Care Act and ways to improve it. I have written often about the Republicans role in sabatoging the ACA making premiums even higher by not funding promised payments to insurers for adverse selection as well as naysaying the law and not expanding Medicaid in 19 states.

This sabatoge continues under this President who says the ACA is in a death spiral. It is hurting in many areas, but stabilizing in others. He said he wants to let it implode and then fix it.

Mr. President, that is not good enough. You are threatening to cease further promised payments to insurance companies which will harm people. You see, what you and Congress fail to realize is you own Obamacare. If it fails, it is on your watch. And, to be frank the significant majority of Americans and the press do not recognize the role you played in hamstringing the imperfect law.

My strong advice is to do what is necessary thinking of its patients and users. Those Americans out there deserve your best efforts to help them. Watching the ACA fail after you greased the skids is extremely poor form and uncaring. It is that simple. Fix the ACA. That is what is done to laws that need it to help people.